title: Biomechanical Analysis of Internal Fixation Methods for Distal Interphalangeal Joint Arthrodesis.
abstract: BACKGROUND
  The biomechanical performance of distal interphalangeal joint (DIPJ) fixation techniques in response to cyclic and load-to-failure bending loads is generally unknown. The purpose of this study is to assess the performance of 4 commonly used techniques for DIP arthrodesis.
  
  
  METHODS
  Phalanges were fixed by one of the following techniques: (1) 2 parallel Kirschner wires (K-wires), (2) 1 longitudinal K-wire and 1 oblique K-wire, (3) an Acutrak® 2 Micro headless compression screw, or (4) 90-90 wiring. The phalanges were loaded in cantilever bending on the palmar side of the phalange for 3000 cycles, then loaded-to-failure.
  
  
  RESULTS
  The 90-90 wiring was significantly worse than the other 3 methods in 9 of 10 parameters analyzed. Both K-wire methods and the screw produced similar results in nearly all parameters.
  
  
  CONCLUSIONS
  Given the lack of difference in biomechanical performance between K-wires and compression screws, consideration should be given to other factors such as cost and complication profiles when choosing an implant for DIPJ fusion.
authors.affiliation: University of Rochester, Rochester, NY, USA.
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Rigot
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Rafael
authors.initials: R
authors.lastname: Diaz-Garcia
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Debski
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Fowler
keywords: biomechanical; distal interphalangeal arthrodesis; headless compression screws; k-wires