Biomechanical analysis of new cross locking plates for metacarpal neck fracture

Yang, Chen-Yuan; Liu, Tingyu; Hsu, Jui‐Ting; Tsai, Ming-Tzu

doi:10.1007/s40846-022-00713-8

Cited by 4 publications

(7 citation statements)

References 29 publications

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“…According to their experimental results, they obtained a stiffness value of only 9.5 ± 1.9 N/mm when a DLP was used for metacarpal bone fixation. This value is much smaller than both the value that we obtained while fixing a bone plate on the dorsal side (64.2 ± 6.3 N/mm) and the value obtained by Yang et al [37] (64.2 ± 6.3 N/mm). Although Jones et al [38] did not conduct a cantilever bending test as in the majority of previous studies, the primary reason underlying this small stiffness value is that although they fractured the metacarpal neck, they simulated a volar wedge defect.…”

Section: Discussioncontrasting

confidence: 76%

“…In addition to studies investigating the fixation of metacarpal shaft fractures, some studies have examined the fracture fixation ability of various techniques at the metacarpal neck. For example, Yang et al [37] examined the ability of a novel cross-locking bone plate to fix metacarpal neck fractures. They reported a stiffness value of 64.2 ± 6.3 N/mm, which is rather close to the value that we obtained while using a conventional bone plate (69.0 ± 13.4 N/mm).…”

Section: Discussionmentioning

confidence: 99%

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Biomechanical study of the fixation ability of the dorsal and volar locking plate for transverse metacarpal neck fractures

Ho,

Hsu,

Wang

et al. 2023

Medicine

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Metacarpal neck fracture is one of the most common types of hand fractures; the literature suggests that applying a bone plate on the dorsal side provides higher fixation strength than that provided by other fixation methods. However, bone plate fixation on the dorsal side may result in postoperative tendon adhesion. So far, no studies have investigated the fixation of metacarpal neck fractures on the volar side by using a bone plate. The objective of this study was to investigate the differences in the fixation results between bone plate fixation on the dorsal side and bone plate fixation on the volar side of the metacarpal in the case of a metacarpal neck fracture. A saw blade was used to create a transverse metacarpal neck fracture on 14 artificial metacarpal bone specimens. The specimens were divided into 2 groups depending on the fixation method: a volar locking plate (VLP) group and a dorsal locking plate (DLP) group. All specimens were subjected to a cantilever bending test on a material testing system, and a force–displacement curve was used to measure the yield force and stiffness, which served as an indicator of the fixation ability of the 2 fracture fixation methods. For the experimental results, the Mann–Whitney U test was used to compare the fixation abilities of the 2 fixation methods. In terms of yield force, the DLP group (266.9 ± 68.3 N) scored significantly higher than the VLP group (32.6 ± 2.7 N) (P < .05); expressed in terms of median, the DLP group scored 8.2 times higher than the VLP group. Similarly, in terms of stiffness, the DLP group (69.0 ± 13.4 N/mm, median ± interquartile range) scored significantly higher than the VLP group (12.9 ± 1.4 N/mm) (P < .05); expressed in terms of median, the DLP group scored 5.3 times higher than the VLP group. The fixation strength of volar bone plates is only about one-third of that of dorsal bone plates.

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Section: Discussioncontrasting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Biomechanical study of the fixation ability of the dorsal and volar locking plate for transverse metacarpal neck fractures

Ho,

Hsu,

Wang

et al. 2023

Medicine

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“…In addition to cantilever bending tests, previous research has utilized various other mechanical testing modes, such as the three-point bending test [26], modified three-point bending test [23,24], four-point bending test [27], and torsional test [19]. Our study employs cantilever bending tests because relevant literature commonly utilizes this method [19,21,22]. Therefore, the present study conducted cantilever bending tests to evaluate the four tested methods.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the research protocols of other studies [19][20][21][22], the present study performed cantilever bending tests to evaluate the four tested methods. Prior to conducting cantilever bending tests, we used molded epoxy clamps to securely hold the proximal end of each artificial third metacarpal bone in a custom fixture.…”

Section: Biomechanical Testmentioning

confidence: 99%

Biomechanical analysis of plate versus K-wire fixation for metacarpal shaft fractures with wedge-shaped bone defects

Chiu,

Ho,

Hsu

et al. 2024

BMC Musculoskelet Disord

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Background Metacarpal shaft fracture is a common type of hand fracture. Numerous studies have explored fixing transverse fractures in the midshaft of the metacarpal bone. However, this section of the metacarpal bone is often susceptible to high-energy injury, resulting in comminuted fracture or bone loss. In such cases, wedge-shaped bone defects can develop in the metacarpal shaft, increasing the difficulty of performing fracture fixation. Notably, the research on this type of fracture fixation is limited. This study compared the abilities of four fixation methods to fix metacarpal shaft fractures with wedge-shaped bone defects. Methods In total, 28 artificial metacarpal bones were used. To create wedge-shaped bone defects, an electric saw was used to create metacarpal shaft fractures at the midshaft of each bone. The artificial metacarpal bones were then divided into four groups for fixation. The bones in the first group were fixed with a dorsal locked plate (DP group), those in the second group were fixed with a volar locked plate (VP group), and those in the third group were fixed by combining dorsal and volar locked plates (DP + VP group), and those in the fourth group were fixed with two K-wires (2 K group). Cantilever bending tests were conducted using a material testing machine to measure yielding force and stiffness. The four groups’ fixation capabilities were then assessed through analysis of variance and Tukey’s test. Results The DP + VP group (164.1±44.0 N) achieved a significantly higher yielding force relative to the 2 K group (50.7 ± 8.9 N); the DP group (13.6 ± 3.0 N) and VP group (12.3 ± 1.0 N) did not differ significantly in terms of yielding force, with both achieving lower yielding forces relative to the DP + VP group and 2 K group. The DP + VP group (19.8±6.3 N/mm) achieved the highest level of stiffness, and the other three groups did not differ significantly in terms of stiffness (2 K group, 5.4 ± 1.1 N/mm; DP group, 4.0 ± 0.9 N/mm; VP group, 3.9 ± 1.9 N/mm). Conclusions The fixation method involving the combined use of dorsal and volar locked plates (DP + VP group) resulted in optimal outcomes with respect to fixing metacarpal shaft fractures with volar wedge bone defects.

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“…Although it has also been confirmed to have a certain degree of stability in some previous biomechanical studies, its ability to resist fracture displacement is not one of its advantages over other surgical methods such as plate-and-screw internal fixation and cortical nail internal fixation. 10 , 11 Additionally, when K-wire fixation is used to treat metacarpal neck fractures, the K-wire must pass through both the articular surface and growth plate. When K-wires pass through the epiphysis, the epiphyseal growth may be affected.…”

Section: Discussionmentioning

confidence: 99%

Treatment of fifth metacarpal neck fracture in adolescents with minimally invasive surgery: percutaneous Kirschner wire fixation versus elastic stable intramedullary nailing

Wang

Deng

et al. 2023

J Int Med Res

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Objective This retrospective study compared two minimally invasive surgical methods for fifth metacarpal neck fractures in adolescents: percutaneous Kirschner wire (K-wire) fixation and elastic stable intramedullary nailing (ESIN). Methods This study involved 42 adolescents aged 11 to 16 years with fifth metacarpal neck fractures treated by either K-wire fixation (n = 20) or ESIN (n = 22). The palmar tilt angle and shortening were compared on radiographs preoperatively and 6 months postoperatively. Total active range of motion (TAM), the visual analogue scale score for pain, and the Disabilities of the Arm, Shoulder and Hand score for upper limb function were recorded at 5 weeks, 3 months, and 6 months postoperatively. Results The mean TAM was significantly greater in the ESIN than K-wire group at all postoperative time points. The mean external fixation time was 2 weeks longer in the K-wire than ESIN group. One patient in the K-wire group developed infection. There was no statistically significant difference between the two groups in other postoperative outcomes. Conclusions ESIN fixation has the advantages of greater stability, better activity, a shorter external fixation time, and a lower infection rate than K-wire fixation in the treatment of fifth metacarpal neck fractures in adolescents.

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Biomechanical analysis of new cross locking plates for metacarpal neck fracture

Cited by 4 publications

References 29 publications

Biomechanical study of the fixation ability of the dorsal and volar locking plate for transverse metacarpal neck fractures

Biomechanical study of the fixation ability of the dorsal and volar locking plate for transverse metacarpal neck fractures

Biomechanical analysis of plate versus K-wire fixation for metacarpal shaft fractures with wedge-shaped bone defects

Treatment of fifth metacarpal neck fracture in adolescents with minimally invasive surgery: percutaneous Kirschner wire fixation versus elastic stable intramedullary nailing

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