Biomechanical evaluation of a new technique for external fixation of unstable supracondylar humerus fractures in children.
BACKGROUND
Closed reduction and percutaneous pinning is regarded as the treatment of choice for unstable supracondylar humerus fractures, but there are cases in which the use of external fixation is preferable.


OBJECTIVE
The aim of this study was to investigate whether the method of external fixation could be considered as a stable alternative to percutaneous pinning and whether there was a difference in stability between two different external fixator constructs.


METHODS
Eighteen synthetic humeri were allocated to three groups of six bones each. The specimens of group 1 were fixed by crossed pinning, those of group 2 by a new variation of an external fixator and the specimens of group 3 by an established variation of it. Osteotomy displacement was measured under static loading in internal and external rotation, as well as in extension and flexion.


RESULTS
The external fixators proved to be significantly more stable than crossed pinning in sagittal loading. In internal rotation loading the new variation of the external fixator showed the best results.


CONCLUSIONS
In case of fractures that can't be replaced by closed reduction the new variation of external fixator should be preferred to the established variation or open reduction and crossed pinning.
Lisa
L
Hohloch
Lukas
L
Konstantinidis
Ferdinand C
FC
Wagner
Peter C
PC
Strohm
Norbert P
NP
Südkamp
Kilian
K
Reising
D001696:Biomechanical Phenomena; D016267:External Fixators; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000601:surgery*; D010027:Osteotomy / Q000379:methods
Supracondylar fracture; biomechanical; crossed pinning; external fixator; pediatric