کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
4071586 1604465 2006 9 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Screw Fixation of Scaphoid Fractures: A Biomechanical Assessment of Screw Length and Screw Augmentation
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی ارتوپدی، پزشکی ورزشی و توانبخشی
پیش نمایش صفحه اول مقاله
Screw Fixation of Scaphoid Fractures: A Biomechanical Assessment of Screw Length and Screw Augmentation
چکیده انگلیسی

PurposeTo assess the biomechanical stability relative to screw length and K-wire augmentation in scaphoid fracture fixation using a flexibility testing protocol and cadaver scaphoids whose soft tissue attachments remained undisturbed. Our hypothesis was 2-fold: increasing screw length and augmenting fixation with a K-wire would improve fracture fragment stability, individually and in combination.MethodsFlexion and extension loading applied through wrist tendons was performed on 10 cadaveric wrists after volar wedge scaphoid osteotomy and internal fixation. Each wrist participated in 3 experimental groups: short screw, long screw, and long screw augmented with a K-wire transfixing the distal pole to the capitate. Interfragmentary displacements were measured.ResultsAnalysis of variance showed significantly less fracture fragment motion with longer screws than with short screws in 4 of the 6 displacement axes. The flexion/extension axis rotations for the short, long, and augmented long-screw groups were 8.2° ± 4.8°, 3.9° ± 1.6°, and 1.8° ± 1.3°, respectively. Although K-wire augmentation reduced displacement of the fracture fragments it did not decrease interfragmentary motion significantly when compared with the long-screw group.ConclusionsUnder physiologically applied loading of cadaveric wrists with unstable scaphoid waist fractures the long screw provided significantly greater stability than the short screw. Although K-wire augmentation in the long-screw group did improve stability the improvements were not significant. Based in part on the biomechanical data from this study it is our recommendation that the optimally placed screw for scaphoid fracture fixation stability is a long screw positioned down the central axis of the scaphoid deep into subchondral bone.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Hand Surgery - Volume 31, Issue 3, March 2006, Pages 405–413
نویسندگان
, , ,