title: Spiral fracture fixation techniques. A biomechanical study.
abstract: The mechanical strengths of five common fixation techniques for spiral fractures have been tested. A total of 240 cadaver metacarpals and proximal phalanges were fractured and fixed by either crossed K-wires, interosseous loops, a dorsal mini-plate, a single compression screw or K-wire plus cerclage wire. Specimens were subjected to torsional and cantilever bending tests. A single compression screw provided the best overall fixation for the proximal phalanx. In addition, a single compression screw provided better fixation than any of the other techniques when proximal phalanges and metacarpals were subjected to torsional tests (P < 0.05). In apex dorsal bending tests of metacarpals, the screw provided fixation superior to interosseous wires, crossed K-wires, or dorsal mini-plates (P < 0.05). These results indicate that the use of a single compression screw provides the most satisfactory biomechanical advantage for spiral fracture fixation.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Medical College of Wisconsin, Milwaukee.
authors.forename: H S
authors.initials: HS
authors.lastname: Matloub
authors.forename: P L
authors.initials: PL
authors.lastname: Jensen
authors.forename: J R
authors.initials: JR
authors.lastname: Sanger
authors.forename: B K
authors.initials: BK
authors.lastname: Grunert
authors.forename: N J
authors.initials: NJ
authors.lastname: Yousif
mesh_terms: D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D001864:Bone Wires; D005383:Finger Injuries / Q000503:physiopathology / Q000601:surgery*; D005592:Fracture Fixation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D006230:Hand Injuries / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008663:Metacarpus / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery