Dmour Awad, Toma Ștefan-Lucian, Cazac Alin-Marian, Tirnovanu Stefan Dragos, Dima Nicoleta, Dmour Bianca-Ana, Popescu Dragos Cristian, Alexa Ovidiu
Department of Orthopedics and Traumatology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Materials Science Department, Materials Science and Engineering Faculty, Gheorghe Asachi Technical University of Iasi, 700050 Iasi, Romania.
Life (Basel). 2024 Dec 19;14(12):1684. doi: 10.3390/life14121684.
This study aims to evaluate and compare the biomechanical performance of two Kirschner (K) wire configurations-the intra-focal and interfragmentary techniques-for the fixation of dorsally displaced distal radius fractures. The study also assesses the impact of K-wire diameter (1.6 mm vs. 2.0 mm) on mechanical stability.
Sixty fresh turkey tarsometatarsus bones were selected and divided into four groups based on the K-wire configuration and diameter used. Fractures were created at standardized locations, and each bone was stabilized using either the intra-focal also known as modified Kapandji (Ka) or interfragmentary technique. Mechanical testing, including axial compression and flexion tests, was performed to assess the biomechanical stability of each configuration.
The interfragmentary configuration consistently demonstrated superior biomechanical performance compared to the intra-focal technique. Specifically, the use of 2.0 mm K-wires resulted in significantly higher axial stiffness (13.28 MPa) and load at break (3070 N) compared to the 1.5 mm wires. Confidence intervals further supported the robustness of these findings. The interfragmentary technique, especially with thicker K-wires, provided greater load-bearing capacity and stiffness.
The interfragmentary technique with 2.0 mm K-wires offers superior mechanical stability compared to the intra-focal technique, making it the preferred choice for stabilizing comminuted extra-articular distal radius fractures. These findings suggest that adopting this technique may reduce the risk of postoperative complications such as fracture displacement or malunion. Further research involving osteoporotic bone models and clinical trials is recommended to validate these findings in real-world settings.
本研究旨在评估和比较两种克氏针（K 针）固定方式——病灶内和骨折块间技术——用于固定桡骨远端背侧移位骨折的生物力学性能。该研究还评估了 K 针直径（1.6 毫米与 2.0 毫米）对机械稳定性的影响。
选取 60 根新鲜火鸡跗跖骨，根据所使用的 K 针固定方式和直径分为四组。在标准化位置制造骨折，每根骨头分别采用病灶内（也称为改良卡潘迪（Ka）技术）或骨折块间技术进行固定。进行包括轴向压缩和弯曲试验在内的力学测试，以评估每种固定方式的生物力学稳定性。
与病灶内技术相比，骨折块间固定方式始终表现出更优的生物力学性能。具体而言，与 1.5 毫米的 K 针相比，使用 2.0 毫米的 K 针可显著提高轴向刚度（13.28 兆帕）和断裂载荷（3070 牛）。置信区间进一步支持了这些研究结果的可靠性。骨折块间技术，尤其是使用较粗 K 针时，具有更大的承载能力和刚度。
与病灶内技术相比，采用 2.0 毫米 K 针的骨折块间技术具有更优的机械稳定性，使其成为稳定粉碎性关节外桡骨远端骨折的首选。这些研究结果表明，采用该技术可能会降低术后并发症（如骨折移位或畸形愈合）的风险。建议开展涉及骨质疏松骨模型和临床试验的进一步研究，以在实际环境中验证这些研究结果。
