Augmented external fixation of distal radius fractures: a biomechanical analysis. 1998

S W Wolfe, and C R Swigart, and J Grauer, and J F Slade, and M M Panjabi
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06520-8071, USA.

An in vitro model of an unstable extra-articular distal radius fracture was created in 8 fresh-frozen cadaveric specimens and stabilized with an external fixator. Rotation and translation kinematics of the distal radial fracture fragment were measured in relation to the proximal radius during physiologic loading, using infrared light-emitting diodes and a 3-dimensional motion-sensing device. The effect of supplemental single and combination Kirschner wire (K-wire) fixation on fracture fragment stability was assessed. Fixation of supplemental K-wires to the fixator frame via a custom-developed outrigger assembly was also analyzed. Significant reductions in sagittal plane (flexion/extension) rotation and neutral zone were recorded when the fracture fragment was stabilized with a single styloid or dorsal transfixion K-wire. Equivalent stability was afforded by attachment of a nontransfixion K-wire to the fixator frame via the outrigger assembly. The dorsal constructs compared favorably to the styloid constructs in reduction of the sagittal plane neutral zone and coronal (radioulnar) rotation. These data lend biomechanical support to the concept of augmentation of distal radius external fixation and provide a physiologic model to test fixation methods for other fracture patterns.

UI MeSH Term Description Entries
D001864 Bone Wires Steel wires, often threaded through the skin, soft tissues, and bone, used to fix broken bones. Kirschner wires or apparatus also includes the application of traction to the healing bones through the wires. Kirschner Wire,Kirschner Wires,Bone Wire,Wire, Bone,Wire, Kirschner,Wires, Bone,Wires, Kirschner
D002102 Cadaver A dead body, usually a human body. Corpse,Cadavers,Corpses
D003100 Colles' Fracture Fracture of the lower end of the radius in which the lower fragment is displaced posteriorly. Colles Fracture,Fracture, Colles'
D005592 Fracture Fixation The use of metallic devices inserted into or through bone to hold a fracture in a set position and alignment while it heals. Skeletal Fixation,Fracture Reduction,Fixation, Fracture,Fixation, Skeletal,Fixations, Fracture,Fixations, Skeletal,Fracture Fixations,Fracture Reductions,Reduction, Fracture,Reductions, Fracture,Skeletal Fixations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013314 Stress, Mechanical A purely physical condition which exists within any material because of strain or deformation by external forces or by non-uniform thermal expansion; expressed quantitatively in units of force per unit area. Mechanical Stress,Mechanical Stresses,Stresses, Mechanical
D014954 Wrist Injuries Injuries to the wrist or the wrist joint. Injuries, Wrist,Injury, Wrist,Wrist Injury
D014955 Wrist Joint The joint that is formed by the distal end of the RADIUS, the articular disc of the distal radioulnar joint, and the proximal row of CARPAL BONES; (SCAPHOID BONE; LUNATE BONE; triquetral bone). Joint, Wrist,Joints, Wrist,Wrist Joints
D016059 Range of Motion, Articular The distance and direction to which a bone joint can be extended. Range of motion is a function of the condition of the joints, muscles, and connective tissues involved. Joint flexibility can be improved through appropriate MUSCLE STRETCHING EXERCISES. Passive Range of Motion,Joint Flexibility,Joint Range of Motion,Range of Motion,Flexibility, Joint
D016267 External Fixators External devices which hold wires or pins that are placed through one or both cortices of bone in order to hold the position of a fracture in proper alignment. These devices allow easy access to wounds, adjustment during the course of healing, and more functional use of the limbs involved. Fixation Devices, External,Device, External Fixation,Devices, External Fixation,External Fixation Device,External Fixation Devices,External Fixator,Fixation Device, External,Fixator, External,Fixators, External

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