Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital South Campus, Shanghai, 201400, China.
Sci Rep. 2024 May 1;14(1):9999. doi: 10.1038/s41598-024-60264-7.
Although tension band wiring (TBW) is popular and recommended by the AO group, the high rate of complications such as skin irritation and migration of the K-wires cannot be ignored. 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 biomechanical testing. We conducted a Synbone biomechanical model by using three fixation methods: DSTBW, intramedullary screw and tension band wiring (IM-TBW), and K-wire TBW, were simulated to fix the olecranon fractures. We compared the mechanical stability of DSTBW, IM-TBW, and TBW in the Mayo Type IIA olecranon fracture Synbone model using a single cycle loading to failure protocol or pullout force. During biomechanical testing, the average fracture gap measurements were recorded at varying flexion angles in three different groups: TBW, IM-TBW, and DSTBW. The TBW group exhibited measurements of 0.982 mm, 0.380 mm, 0.613 mm, and 1.285 mm at flexion angles of 0°, 30°, 60°, and 90° respectively. The IM-TBW group displayed average fracture gap measurements of 0.953 mm, 0.366 mm, 0.588 mm, and 1.240 mm at each of the corresponding flexion angles. The DSTBW group showed average fracture gap measurements of 0.933 mm, 0.358 mm, 0.543 mm, and 1.106 mm at the same flexion angles. No specimen failed in each group during the cyclic loading phase. Compared with the IM-TBW and TBW groups, the DSTBW group showed significant differences in 60° and 90° flexion angles. The mean maximum failure load was 1229.1 ± 110.0 N in the DSTBW group, 990.3 ± 40.7 N in the IM-TBW group, and 833.1 ± 68.7 N in the TBW group. There was significant difference between each groups (p < 0.001).The average maximum pullout strength for TBW was measured at 57.6 ± 5.1 N, 480.3 ± 39.5 N for IM-TBW, and 1324.0 ± 43.8 N for DSTBW. The difference between maximum pullout strength of both methods was significant to p < 0.0001. DSTBW fixation provides more stability than IM-TBW and TBW fixation models for olecranon fractures.
虽然张力带钢丝固定（TBW）是 AO 集团推荐的，但皮肤刺激和 K 线迁移等并发症的高发率不容忽视。丁氏螺钉张力带固定（DSTBW）是一种新的 TBW 技术，在治疗其他类型的骨折方面已取得积极成果。本研究旨在通过生物力学测试评估 DSTBW 治疗尺骨鹰嘴骨折的稳定性。我们使用三种固定方法模拟 Synbone 生物力学模型：DSTBW、髓内螺钉和张力带钢丝固定（IM-TBW）以及 K 线 TBW 固定尺骨鹰嘴骨折。我们比较了 DSTBW、IM-TBW 和 TBW 在 Mayo Type IIA 鹰嘴骨折 Synbone 模型中的机械稳定性，使用单循环加载至失效协议或拔出力。在生物力学测试中，在三个不同组（TBW、IM-TBW 和 DSTBW）中，在不同的弯曲角度记录平均骨折间隙测量值。TBW 组在 0°、30°、60°和 90°的弯曲角度下的测量值分别为 0.982mm、0.380mm、0.613mm 和 1.285mm。IM-TBW 组的平均骨折间隙测量值分别为 0.953mm、0.366mm、0.588mm 和 1.240mm。DSTBW 组在相同的弯曲角度下的平均骨折间隙测量值分别为 0.933mm、0.358mm、0.543mm 和 1.106mm。在每个循环加载阶段，每组均未出现标本失效。与 IM-TBW 和 TBW 组相比，DSTBW 组在 60°和 90°弯曲角度下差异有统计学意义。DSTBW 组的平均最大失效载荷为 1229.1±110.0N，IM-TBW 组为 990.3±40.7N，TBW 组为 833.1±68.7N。各组之间差异有统计学意义（p<0.001）。TBW 的平均最大拔出强度为 57.6±5.1N，IM-TBW 为 480.3±39.5N，DSTBW 为 1324.0±43.8N。两种方法的最大拔出强度差异有统计学意义（p<0.0001）。DSTBW 固定比 IM-TBW 和 TBW 固定模型更能为尺骨鹰嘴骨折提供稳定性。
