Effect of a figure-of-eight cerclage wire with two Kirschner wires on fixation strength for transverse metacarpal shaft fractures: an in vitro study with artificial bone

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

doi:10.1186/s12891-021-04276-8

Cited by 4 publications

(7 citation statements)

References 43 publications

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“…Although numerous in vitro biomechanical studies have employed artificial bones to investigate effectiveness of metacarpal fracture fixation, most of these studies have investigated the fracture fixation ability of metacarpal shaft fracture fixation methods. [16,24,[30][31][32][33] In addition to conducting a cantilever bending test for evaluation, Chiu et al [16] used a dorsal bone plate to fix a metacarpal shaft fracture. They reported a stiffness value of 68.7 ± 14.0 N/mm, which is rather similar to the value that we obtained while fixing a metacarpal neck fracture by using a dorsal bone plate (69.0 ± 13.4 N/ mm).…”

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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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: 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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“…This is associated with extensive soft tissue dissection and postsurgical complications, including tendon adhesion, scar contracture, and joint stiffness [ 23 ]. By contrast, the use of lag screws to treat oblique metacarpal shaft fractures has resulted in favorable outcomes and does not require extensive soft tissue dissection around the fracture site [ 19 , 20 ]. Treatment is generally effective when lag screw fixation is performed.…”

Section: Discussionmentioning

confidence: 99%

“…Lag screw fixation can be more favorable for a larger fracture zone in oblique fractures. In addition to not causing complications normally associated with bone plate fixation, lag screw fixation involves shorter surgical incisions, less soft tissue dissection, lower costs, and shorter operating times [ 19 , 20 , 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, even if such fresh bones were obtained, ensuring that all specimens possessed similar material properties would be impossible. Therefore, similar to most studies [ 1 , 7 , 20 , 29 ], we used artificial bone instead of human metacarpal bone. Second, we performed the cantilever bending test to evaluate the effectiveness of different fixation methods for horizontal oblique metacarpal shaft fractures; this method was similarly used in other studies [ 19 , 20 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, similar to most studies [ 1 , 7 , 20 , 29 ], we used artificial bone instead of human metacarpal bone. Second, we performed the cantilever bending test to evaluate the effectiveness of different fixation methods for horizontal oblique metacarpal shaft fractures; this method was similarly used in other studies [ 19 , 20 , 30 ]. However, the movement of this loading model differs from that of real hands.…”

Section: Discussionmentioning

confidence: 99%

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Biomechanical study on fixation methods for horizontal oblique metacarpal shaft fractures

Chiu

Hsu

et al. 2022

J Orthop Surg Res

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Objective To investigate differences in the effectiveness of two lag screws, a regular bone plate, and locking bone plate fixation in treating horizontal oblique metacarpal shaft fractures. Materials and methods Horizontal oblique metacarpal shaft fractures were created in 21 artificial metacarpal bones and fixed using one of the three methods: (1) two lag screws, (2) a regular plate, and (3) a locking plate. All the specimens were subjected to the cantilever bending test performed using a material testing machine to enable recording of the force–displacement data of the specimens before failure. The Kruskal–Wallis test was used to compare failure force and stiffness values among the three fixation methods. Results The mean failure force of the two lag screw group (78.5 ± 6.6 N, mean + SD) was higher than those of the regular plate group (69.3 ± 17.6 N) and locking plate group (68.2 ± 14.2 N). However, the mean failure force did not significantly differ among the three groups. The mean stiffness value of the two lag screw group (17.8 ± 2.6 N/mm) was lower than those of the regular plate group (20.2 ± 10.5 N/mm) and locking plate group (21.8 ± 3.8 N/mm). However, the mean stiffness value did not significantly differ among the three groups. Conclusion The fixation strength of two lag screw fixation did not significantly differ from that of regular and locking bone plate fixation, as indicated by the measurement of the ability to sustain force and stiffness.

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Curative effect of external fixation combined with kirschner wire versus hollow screw in the treatment of first metacarpal bone base fracture

Liu,

Lu,

Zhao

et al. 2023

BMC Musculoskelet Disord

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Purpose This study was conducted aimed at comparing the curative effect of external fixation combined with Kirschner wire fixation versus hollow screw fixation in the treatment of first metacarpal bone base fracture. Methods The current retrospective study included a total of 80 patients diagnosed with first metacarpal bone base fracture who were admitted in Wuxi 9th People’s Hospital Affiliated to Soochow University between October 2017 and October 2020. The patients enrolled were equally divided into the combined group (40 cases, receiving external fixation combined with Kirschner wire fixation), and the control group (40 cases, receiving hollow screw fixation). Perioperative indices were collected and compared between the two groups. Pain scores before operation and three months, six months, and one year after operation were compared. Additionally, we compared the finger function in the last follow-up visit ( the follow-up period was 1 year) and rate of complications. Results Operation time, amount of bleeding, length of incision, length of hospital stay, and fracture healing time did not differ between the two groups (all P > 0.05). Pain score was comparable between the two groups before operation (P = 0.704). Despite lower results showing at 3, 6, and 12 months after operation in both groups, the pain score did not significantly differ in any time point between the two groups (all P > 0.05). Additionally, no significant differences were observed in finger function and rate of complications at the last follow-up between the two groups (both P > 0.05). Conclusion External fixation combined with Kirschner wire fixation and hollow screw fixation exhibited similar curative effect in treating first metacarpal bone base fracture, indicating both surgery methods may be considered as the preferred approach.

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Effect of a figure-of-eight cerclage wire with two Kirschner wires on fixation strength for transverse metacarpal shaft fractures: an in vitro study with artificial bone

Cited by 4 publications

References 43 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 study on fixation methods for horizontal oblique metacarpal shaft fractures

Curative effect of external fixation combined with kirschner wire versus hollow screw in the treatment of first metacarpal bone base fracture

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