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Biomechanical comparison of the use of a Kirschner wire or a plate as adjunctive epicondylar fixation during lateral unicondylar humeral fracture stabilization


Coggeshall, Jason D; Lewis, Daniel D; Iorgulescu, Alex; Kim, Stanley E; Palm, Lindsey; Pozzi, Antonio (2017). Biomechanical comparison of the use of a Kirschner wire or a plate as adjunctive epicondylar fixation during lateral unicondylar humeral fracture stabilization. Veterinary Surgery, 46(7):933-941.

Abstract

OBJECTIVE: To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2.7 mm reconstruction plate as adjunctive epicondylar stabilization in simulated comminuted lateral unicondylar humeral fractures stabilized with a transcondylar 4.5 mm cortical screw.
STUDY DESIGN: Cadaveric biomechanical assessment.
SAMPLE POPULATION: Paired humeri harvested from 9 young, skeletally mature dogs.
METHODS: Simulated comminuted lateral unicondylar humeral fractures were stabilized with a transcondylar 4.5 mm cortical screw placed in lag fashion. Adjunct fixations consisting of a 1.6 mm Kirschner wire on one side, and a 2.7 mm reconstruction plate on the contralateral side, were tested within paired humeri. Repaired humeri were axially loaded to failure and construct stiffness, yield load, and load to failure were obtained from the load-deformation curves.
RESULTS: Stiffness (mean ± SD: 577 ± 245 vs 310 ± 71 N/mm; P = .01), yield load (mean ± SD: 2389 ± 572 vs 1017 N ± 292; P = .0002), and load at failure (mean ± SD: 3351 ± 358 vs 1693 ± 363 N; P = .009) were greater in constructs incorporating a reconstruction plate rather than a Kirschner wire.
CONCLUSION: Our results support the recommendation for adjunct fixation of comminuted lateral unicondylar humeral fractures with an epicondylar plate.

Abstract

OBJECTIVE: To compare the biomechanical properties of using an interfragmentary 1.6 mm Kirschner wire or a 2.7 mm reconstruction plate as adjunctive epicondylar stabilization in simulated comminuted lateral unicondylar humeral fractures stabilized with a transcondylar 4.5 mm cortical screw.
STUDY DESIGN: Cadaveric biomechanical assessment.
SAMPLE POPULATION: Paired humeri harvested from 9 young, skeletally mature dogs.
METHODS: Simulated comminuted lateral unicondylar humeral fractures were stabilized with a transcondylar 4.5 mm cortical screw placed in lag fashion. Adjunct fixations consisting of a 1.6 mm Kirschner wire on one side, and a 2.7 mm reconstruction plate on the contralateral side, were tested within paired humeri. Repaired humeri were axially loaded to failure and construct stiffness, yield load, and load to failure were obtained from the load-deformation curves.
RESULTS: Stiffness (mean ± SD: 577 ± 245 vs 310 ± 71 N/mm; P = .01), yield load (mean ± SD: 2389 ± 572 vs 1017 N ± 292; P = .0002), and load at failure (mean ± SD: 3351 ± 358 vs 1693 ± 363 N; P = .009) were greater in constructs incorporating a reconstruction plate rather than a Kirschner wire.
CONCLUSION: Our results support the recommendation for adjunct fixation of comminuted lateral unicondylar humeral fractures with an epicondylar plate.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Department of Small Animals
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Language:English
Date:22 June 2017
Deposited On:18 Aug 2017 15:51
Last Modified:09 Dec 2017 01:44
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0161-3499
Additional Information:This is the peer reviewed version of the following article: Coggeshall JD, Lewis DD, Iorgulescu A, Kim SE, Palm LS, Pozzi A. Adjunct fixation with a Kirschner wire or a plate for lateral unicondylar humeral fracture stabilization. Veterinary Surgery. 2017;00:1-9, which has been published in final form at https://doi.org/10.1111/vsu.12677. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving (http://olabout.wiley.com/WileyCDA/Section/id-820227.html#terms).
Publisher DOI:https://doi.org/10.1111/vsu.12677
PubMed ID:28640455

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