Biomechanical comparison of fixation of two-part osteoporotic neck fracture of the proximal humerus using uni-planar and multi-planar Kirschner wire Humerus proksimal uç iki parçalı kırıklarının tek yönlü ve çok yönlü Kirschner teli ile tespitinin biyomekanik olarak karşılaştırılması


ESEN E., DOĞRAMACI Y., Kömürcü M., KANATLI U., Bolukbasi S. S., Atahan A. O.

Eklem Hastaliklari ve Cerrahisi, vol.20, no.2, pp.114-118, 2009 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 2
  • Publication Date: 2009
  • Journal Name: Eklem Hastaliklari ve Cerrahisi
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.114-118
  • Keywords: Biomechanics, Fracture, Osteoporosis, Proximal humerus
  • Hatay Mustafa Kemal University Affiliated: Yes

Abstract

Objectives: The stability and effectiveness of uni-planar Kirschner wire (K-wires) was compared to multi-planar K-wires osteosynthesis combined with tension band wiring for fixation of two-part osteoporotic surgical neck fracture of the proximal humerus. Materials and methods: Two groups each with eight cadaveric elderly (mean age 72.6; range 70 to 80 year) frozen human humeri were used in the study. Transverse osteotomy of the proximal humerus was performed using a thin oscillating saw. The first group (group A) was fixed using two anterograde smooth K-wires, sent from lateral cortex, combined with tension band wiring. The second group (group B) was fixed using multi-planar (anterograde and retrograde) four smooth K-wires combined with tension band wiring on the lateral cortex. Biomechanical tensile properties for 3 mm displacement (gap load) and maximum load were assessed. Results: The mean value for the gap load was 1045.0±45.4 N (Newton) for group A and 1238.1±115.8 N for group B. Gap load values of groups were similar (p=0.01). The maximum load was 1261.8±52.4 N in group A and 1471.1±107.3 N in group B. The maximum load values were statistically higher in the multiplanar fixation technique (group B) when compared to that of the uniplanar fixation technique (group A), (p=0.004). Conclusion: Fixation in osteoporotic two-part surgical neck fractures of the proximal humerus using multiplanar K-wires combined with tension band wire provides substantially more effective stability compared to that of uniplanar fixation.