Biomechanical study on fixation methods for horizontal oblique metacarpal shaft fractures

Chiu, Yung-Cheng; Hsu, Chiann‐Yi; Ho, Tsung-Yu; Ting, Yen-Nien; Tsai, Ming-Tzu; Hsu, Jui‐Ting

doi:10.1186/s13018-022-03267-2

Cited by 4 publications

(2 citation statements)

References 29 publications

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“…We did not pre-drill or saw the bone. This is a distinct advantage compared with other studies that have used sawbones or 3-D printed bones (Chiu et al., 2022; White et al., 2021). We also recognized several limitations to this study.…”

Section: Discussionmentioning

confidence: 97%

Comparing the torsional resistance of different fixation techniques for spiral metacarpal fractures

Choke

Wong

Quek

et al. 2023

J Hand Surg Eur Vol

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This study aimed to compare the torsional resistance of three fixation techniques for spiral metacarpal fractures: screw-only fixation, screw plus neutralization plate fixation, and a locking plate construct. A spiral fracture was created on 18 cadaveric metacarpal bones by applying an axial and torsional loading force using an Instron 3343 mechanical tester. The failure strength was defined as the native torque strength. The fractures were divided into three groups and fixed using each of the three techniques. The repaired bones were loaded to failure to determine the post-repair strength. The neutralization plate group conferred a post-repair torque (278.6 Nmm) that was similar to the native torque (292 Nmm) with a diminution of only 4.5% and appeared to provide the best resistance to torsion.

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Section: Discussionmentioning

confidence: 97%

Comparing the torsional resistance of different fixation techniques for spiral metacarpal fractures

Choke

Wong

Quek

et al. 2023

J Hand Surg Eur Vol

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“…Torsional loading and cantilever bending were chosen to simulate common postoperative motions, as precedented by previous fracture fixation biomechanical studies. 18 , 24 , 27 , 28 Finally, to assess structural stability, specimens were loaded to failure under cantilever bending at a rate of 1 mm/s 20 , 21 …”

Section: Methodsmentioning

confidence: 99%

Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation

Wahbeh,

Kelley,

Shokoohi

et al. 2023

OTA International: The Open Access Journal of Orthopaedic Trauma

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Objectives: Implant prominence after ulnar fracture fixation may be mitigated by the use of lower profile plates. The biomechanical strength and stability of 2.7-mm and 3.5-mm locking compression plates for fixation were compared. Methods: Two fracture conditions, transverse (N = 10) and oblique (N = 10), were evaluated in an in vitro study. Half of the specimens for each condition were fixed with 2.7-mm plates and the other half with 3.5-mm plates, all fixed with conventional dynamic compression mechanisms. Specimens were loaded under ±2 Nm of cyclic axial torsion, then under 10 Nm of cyclic cantilever bending, and bending to failure. Interfragmentary motion and strain were analyzed to determine construct stability as a function of fracture pattern and plate size. Results: Interfragmentary motion was significantly larger in all constructs fixed with 2.7-mm plates, compared with 3.5-mm plates (P < 0.01). The 2.7-mm constructs with transverse fractures had the greatest motion, ranging between 5° and 10° under axial rotation and 5.0–6.0 mm under bending. Motions were the lowest for 3.5-mm constructs with oblique fractures, ranging between 3.2 and 4.2 mm under bending and 2°–3.5° for axial rotation. For oblique fractures, the bending moment at ultimate failure was 31.4 ± 3.6 Nm for the 2.7-mm constructs and 10.0 ± 1.9 Nm for 3.5-mm constructs (P < 0.01). Similarly, for transverse fractures, the bending moment was 17.9 ± 4.0 Nm for the 2.7-mm constructs and 9.7 ± 1.3 Nm for the 3.5-mm constructs (P < 0.01). Conclusions: Although 3.5-mm plates were more effective at reducing fracture motion, they were consistently associated with refracture at the distal-most screw hole under load to failure. By contrast, 2.7-mm plates plastically deformed despite excessive loads, potentially avoiding a subsequent fracture. Level of Evidence: Level V.

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Percutaneous transverse pinning for metacarpal fractures: a clinical trial

Pintore,

Astone,

Vecchio

et al. 2024

Arch Orthop Trauma Surg

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Introduction Metacarpal fractures account for 25%-50% of all hand fractures and may negatively impact hand function and ability to work. Percutaneous transverse pinning of non-articular metacarpal fractures allows mobilisation immediately after the procedure. Methods Between March 2017 and February 2022, 56 patients undergoing percutaneous transverse pinning for unstable metacarpal fractures were prospectively recruited. We investigated surgical outcomes in terms of Patient-rated Wrist/Hand Evaluation (PRWHE) and pre-and post-operative radiographic evaluation. The Student t-test was used to compare the means of PRWHE values after surgery. Statistical significance was set at p < 0.05. Results The mean age was 40.21 ± 17.9 years (range of 16 to 86 years). The average operating time was 27.96 min. The mean follow-up period was 14.3 ± 6.4 months (from 2 to 41 months). The mean PRWHE score was 6.5 ± 1.8. None of the patients had clinically observable rotational deformities, and the functional outcomes were satisfactory. Conclusion Percutaneous transverse pinning for non-articular metacarpal fractures restores excellent function, and imaging results are satisfactory. Further high-quality clinical trials are required to validate these results on a larger scale. Level of evidence II, prospective cohort study.

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Biomechanical study on fixation methods for horizontal oblique metacarpal shaft fractures

Cited by 4 publications

References 29 publications

Comparing the torsional resistance of different fixation techniques for spiral metacarpal fractures

Comparing the torsional resistance of different fixation techniques for spiral metacarpal fractures

Comparison of a 2.7-mm and 3.5-mm locking compression plate for ulnar fractures: a biomechanical evaluation

Percutaneous transverse pinning for metacarpal fractures: a clinical trial

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