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Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis
BACKGROUND: Patients with a simple transversal fracture of the olecranon are often treated with a tension band wiring (TBW), because it is known as a biomechanically appropriate and cost-effective procedure. Nevertheless, the technique is in detail more challenging than thought, resulting in a consi...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781390/ https://www.ncbi.nlm.nih.gov/pubmed/31594540 http://dx.doi.org/10.1186/s40001-019-0392-7 |
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author | Nowotny, J. Bischoff, F. Ahlfeld, T. Goronzy, J. Tille, E. Nimtschke, U. Biewener, A. |
author_facet | Nowotny, J. Bischoff, F. Ahlfeld, T. Goronzy, J. Tille, E. Nimtschke, U. Biewener, A. |
author_sort | Nowotny, J. |
collection | PubMed |
description | BACKGROUND: Patients with a simple transversal fracture of the olecranon are often treated with a tension band wiring (TBW), because it is known as a biomechanically appropriate and cost-effective procedure. Nevertheless, the technique is in detail more challenging than thought, resulting in a considerable high rate of implant-related complications like k-wire loosening and soft tissue irritation. In the literature, a distinction is generally only made between transcortical (bi-) and intramedullary (mono-) fixation of the wires. There is the additional possibility to fix the proximal bent end of k-wire in the cortex of the bone and thus create a tricortical fixation. The present study investigates the effectiveness of bi- and tricortical k-wire fixation in a biomechanical approach. METHODS: TBW of the olecranon was performed at 10 cadaver ulnas from six donors in a usual manner and divided into two groups: In group 1, the k-wire was inserted by bicortical fixation (BC), and in group 2, a tricortical fixation (TC) was chosen. Failure behavior and maximum pullout strength were assessed and evaluated by using a Zwick machine. The statistical evaluation was descriptive and with a paired t test for the evaluation of significances between the two techniques. RESULTS: The average age of the used donors was 81.5 ± 11.5 (62–92) years. Three donors were female, and three were male. Ten k-wires were examined in BC group and 10 in the TC group. The mean bone density of the used proximal ulnas was on average 579 ± 186 (336–899) HU. The maximum pullout strength was 263 ± 106 (125–429) N in the BC group and increased significantly in the TC group to 325 ± 102 (144–466) N [p = .005]. CONCLUSION: This study confirms for the first time biomechanical superiority of tricortical k-wire fixation in the olecranon when using a TBW and may justify the clinical use of this method. |
format | Online Article Text |
id | pubmed-6781390 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67813902019-10-17 Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis Nowotny, J. Bischoff, F. Ahlfeld, T. Goronzy, J. Tille, E. Nimtschke, U. Biewener, A. Eur J Med Res Research BACKGROUND: Patients with a simple transversal fracture of the olecranon are often treated with a tension band wiring (TBW), because it is known as a biomechanically appropriate and cost-effective procedure. Nevertheless, the technique is in detail more challenging than thought, resulting in a considerable high rate of implant-related complications like k-wire loosening and soft tissue irritation. In the literature, a distinction is generally only made between transcortical (bi-) and intramedullary (mono-) fixation of the wires. There is the additional possibility to fix the proximal bent end of k-wire in the cortex of the bone and thus create a tricortical fixation. The present study investigates the effectiveness of bi- and tricortical k-wire fixation in a biomechanical approach. METHODS: TBW of the olecranon was performed at 10 cadaver ulnas from six donors in a usual manner and divided into two groups: In group 1, the k-wire was inserted by bicortical fixation (BC), and in group 2, a tricortical fixation (TC) was chosen. Failure behavior and maximum pullout strength were assessed and evaluated by using a Zwick machine. The statistical evaluation was descriptive and with a paired t test for the evaluation of significances between the two techniques. RESULTS: The average age of the used donors was 81.5 ± 11.5 (62–92) years. Three donors were female, and three were male. Ten k-wires were examined in BC group and 10 in the TC group. The mean bone density of the used proximal ulnas was on average 579 ± 186 (336–899) HU. The maximum pullout strength was 263 ± 106 (125–429) N in the BC group and increased significantly in the TC group to 325 ± 102 (144–466) N [p = .005]. CONCLUSION: This study confirms for the first time biomechanical superiority of tricortical k-wire fixation in the olecranon when using a TBW and may justify the clinical use of this method. BioMed Central 2019-10-08 /pmc/articles/PMC6781390/ /pubmed/31594540 http://dx.doi.org/10.1186/s40001-019-0392-7 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Nowotny, J. Bischoff, F. Ahlfeld, T. Goronzy, J. Tille, E. Nimtschke, U. Biewener, A. Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis |
title | Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis |
title_full | Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis |
title_fullStr | Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis |
title_full_unstemmed | Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis |
title_short | Biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis |
title_sort | biomechanical comparison of bi- and tricortical k-wire fixation in tension band wiring osteosynthesis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781390/ https://www.ncbi.nlm.nih.gov/pubmed/31594540 http://dx.doi.org/10.1186/s40001-019-0392-7 |
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