title: Comparative fatigue strengths and stabilities of metacarpal internal fixation techniques.
abstract: To study quantitative differences in the fatigue strength and stability obtained with 5 types of internal fixation of metacarpal fractures, 105 preserved human metacarpals were cyclically tested in bending, torsion, and axial loading after oblique osteotomies of the metacarpal and internal fixation. The dorsal plate with lag screw was superior in all modes, followed by the two dorsal lag screws, crossed Kirschner wire tension banding, and intramedullary Kirschner wire fixation. The five intramedullary and the paired intramedullary Kirschner wire fixations were not statistically different. The fatigue life of the plate fixation was significantly larger in bending (1.5 times), torsion (1.6 times), and axial loading (2.5 times) than the second strongest fixation, two dorsal lag screws. Its initial rigidity was significantly higher in axial loading (1.5 times) but was not statistically different in bending and torsion.
authors.affiliation: Department of Orthopaedics and Rehabilitation, School of Medicine, University of New Mexico, Albuquerque 87131-5296.
authors.forename: K K
authors.initials: KK
authors.lastname: Firoozbakhsh
authors.forename: M S
authors.initials: MS
authors.lastname: Moneim
authors.forename: T
authors.initials: T
authors.lastname: Howey
authors.forename: E
authors.initials: E
authors.lastname: Castaneda
authors.forename: M A
authors.initials: MA
authors.lastname: Pirela-Cruz
mesh_terms: D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods; D050723:Fractures, Bone / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D066298:In Vitro Techniques; D016268:Internal Fixators; D008663:Metacarpus / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D013314:Stress, Mechanical