Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, 201400, China.
BMC Musculoskelet Disord. 2023 Jul 24;24(1):603. doi: 10.1186/s12891-023-06684-4.
Tension band wiring (TBW) is a common surgical intervention for olecranon fractures. However, high rate of complications such as loss of reduction, skin irritation, and migration of the K-wires were reported up to 80%. Ding's screw tension band wiring (DSTBW) is a new TBW technique that has shown positive results in the treatment of other fracture types. The objective of this study was to evaluate the stability of DSTBW in the treatment of olecranon fractures by finite element analysis.
We used Ding's screw tension band fixation (DSTBW) and K-wire tension band fixation (TBW) to establish a finite element model to simulate and fix olecranon fractures. The stress distribution, opening angle, twisting angle, and pullout strength of K-wires or screws were analyzed and compared.
The maximum von Mises stress was observed on the internal fixation for 90° elbow motion in both groups. The von Mises value of the screw in DSTBW was 241.2 MPa, and the von Mises value of k-wire in TBW was 405.0 MPa. Opening angle: TBW was 0.730° and DSTBW was 0.741° at 45° flexion; TBW was 0.679° and DSTBW was 0.693° at 90° flexion. Twisting angle: TBW was 0.146° and DSTBW was 0.180° at 45° flexion; TBW was 0.111° and DSTBW was 0.134° at 90° flexion. The pullout strength of DSTBW was significantly higher than that of TBW. Maximum pullout strength of Ding's screw was 2179.1 N, maximum pullout strength of K-wire was 263.6 N.
DSTBW technology provides stable fixation for olecranon fractures, reducing the risk of internal fixation migration and failure.
张力带钢丝固定（TBW）是治疗尺骨鹰嘴骨折的常用手术方法。然而，高达 80%的患者报告存在诸如复位丢失、皮肤刺激和克氏针迁移等并发症。丁氏螺钉张力带钢丝固定（DSTBW）是一种新的 TBW 技术，在治疗其他类型骨折方面已显示出积极的效果。本研究旨在通过有限元分析评估 DSTBW 治疗尺骨鹰嘴骨折的稳定性。
我们使用丁氏螺钉张力带固定（DSTBW）和克氏针张力带固定（TBW）建立有限元模型，模拟并固定尺骨鹰嘴骨折。分析和比较了两种内固定方式下的应力分布、开口角度、扭转角度和克氏针或螺钉的拔出强度。
两组在 90°肘部运动时，内固定的最大 von Mises 应力均最大。DSTBW 中螺钉的 von Mises 值为 241.2 MPa，TBW 中克氏针的 von Mises 值为 405.0 MPa。开口角度：TBW 在 45°屈曲时为 0.730°，DSTBW 为 0.741°；TBW 在 90°屈曲时为 0.679°，DSTBW 为 0.693°。扭转角度：TBW 在 45°屈曲时为 0.146°，DSTBW 为 0.180°；TBW 在 90°屈曲时为 0.111°，DSTBW 为 0.134°。DSTBW 的拔出强度明显高于 TBW。DSTBW 中螺钉的最大拔出强度为 2179.1 N，克氏针的最大拔出强度为 263.6 N。
DSTBW 技术为尺骨鹰嘴骨折提供了稳定的固定，降低了内固定物迁移和失效的风险。
