A new configuration of lateral-pin fixation for pediatric supracondylar humeral fracture: A biomechanical analysis


Bilgili F., DEMİREL M., Birişik F., Balcı H. İ., Sünbüloğlu E., Bozdağ S. E.

Acta Orthopaedica et Traumatologica Turcica, cilt.58, sa.2, ss.110-115, 2024 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 58 Sayı: 2
  • Basım Tarihi: 2024
  • Doi Numarası: 10.5152/j.aott.2024.21091
  • Dergi Adı: Acta Orthopaedica et Traumatologica Turcica
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.110-115
  • Anahtar Kelimeler: Biomechanical analysis, Crossed pins, Lateral divergent pins, Pediatric supracondylar humerus fracture, Torsional stability
  • İstanbul Üniversitesi Adresli: Evet

Özet

Objective: The aim of this study was to biomechanically compare a new lateral-pinning technique, in which pins engage the medial and lateral columns of the distal humerus in a divergent configuration in both the axial and sagittal planes instead of the coronal plane, with the cross-pin, and with 2 and 3 coronally divergent lateral-pin techniques in a synthetic humerus model of supracondylar humerus fractures. Methods: Thirty-six identical synthetic models of the humerus simulating a standardized supracondylar humerus fracture were included in this study. They were divided into 4 groups based on the pin configuration of fixation: the new 3-lateral pin-fixation technique (group A), 2 crossed pins (group B), 3 divergent lateral pins (group C), and 2 divergent lateral pins (group D). Each model was subjected to combined axial and torsional loading, and then torsional stability and torsional stiffness (N mm/°) were recorded. Results: Group A had greater rotational stability than groups C and D but had no statistically significant additional rotational stability compared with group B (P =.042, P =.008, P =.648, respectively), whereas group B had greater rotational stability than only group D (P =.020). Furthermore, group A demonstrated higher internal rotational stiffness compared with groups C and D (P =.038, P =.006, respectively). Group B had better internal rotational stiffness than group D (P =.015). There was no significant difference in internal rotational stiffness between groups A and B (P =. 542), groups B and C (P =.804), and groups D and C (P =.352). Although no statistically significant differences existed between groups A and B, the modified pin configuration exhibited the highest torsional stability and stiffness. Group D showed the lowest values in all biomechanical properties. Conclusion: This study has shown us that this new lateral-pinning technique may provide torsional resistance to internal rotational displacement as strong as the standard technique of crossed-pin configuration of fixation. Furthermore, with this new pin configuration, greater torsional resistance can be obtained than with either the standard 2-or the standard 3-lateral divergent pin configuration.