TY - JOUR A1 - Rausch, Valentin A1 - Harbrecht, Andreas A1 - Kahmann, Stephanie Lucina A1 - Fenten, Thomas A1 - Jovanovic, Nebojsa A1 - Hackl, Michael A1 - Müller, Lars P. A1 - Staat, Manfred A1 - Wegmann, Kilian T1 - Osteosynthesis of Phalangeal Fractures: Biomechanical Comparison of Kirschner Wires, Plates, and Compression Screws JF - The Journal of Hand Surgery N2 - Purpose The aim of this study was to compare several osteosynthesis techniques (intramedullary headless compression screws, T-plates, and Kirschner wires) for distal epiphyseal fractures of proximal phalanges in a human cadaveric model. Methods A total of 90 proximal phalanges from 30 specimens (index, ring, and middle fingers) were used for this study. After stripping off all soft tissue, a transverse distal epiphyseal fracture was simulated at the proximal phalanx. The 30 specimens were randomly assigned to 1 fixation technique (30 per technique), either a 3.0-mm intramedullary headless compression screw, locking plate fixation with a 2.0-mm T-plate, or 2 oblique 1.0-mm Kirschner wires. Displacement analysis (bending, distraction, and torsion) was performed using optical tracking of an applied random speckle pattern after osteosynthesis. Biomechanical testing was performed with increasing cyclic loading and with cyclic load to failure using a biaxial torsion-tension testing machine. Results Cannulated intramedullary compression screws showed significantly less displacement at the fracture site in torsional testing. Furthermore, screws were significantly more stable in bending testing. Kirschner wires were significantly less stable than plating or screw fixation in any cyclic load to failure test setup. Conclusions Intramedullary compression screws are a highly stable alternative in the treatment of transverse distal epiphyseal phalangeal fractures. Kirschner wires seem to be inferior regarding displacement properties and primary stability. Clinical relevance Fracture fixation of phalangeal fractures using plate osteosynthesis may have the advantage of a very rigid reduction, but disadvantages such as stiffness owing to the more invasive surgical approach and soft tissue irritation should be taken into account. Headless compression screws represent a minimally invasive choice for fixation with good biomechanical properties. Y1 - 2020 U6 - http://dx.doi.org/10.1016/j.jhsa.2020.04.010 SN - 0363-5023 VL - 45 IS - 10 SP - 987.e1 EP - 987.e8 PB - Elsevier CY - Amsterdam ER - TY - JOUR A1 - Wegmann, Kilian A1 - Hackl, Michael A1 - Staat, Manfred A1 - Mayer, Katharina A1 - Müller, Lars-Peter T1 - Double plate osteosynthesis of proximal ulna fractures: biomechanical and clinical results JF - Knee surgery, sports traumatology, arthroscopy N2 - While plate fixation of proximal ulna fractures might lead to superior clinical results compared to tension band wiring, regular plates represent an established risk factor for wound complications. The olecranon double plates (Medartis, Basel, CH) might decrease complications related to the osteosynthesis because of their low profile and better anatomical fit. This study aimed to evaluate the biomechanical performance and clinical results of the olecranon double plates. Y1 - 2016 U6 - http://dx.doi.org/10.1007/s00167-016-4079-0 SN - 0942-2056 VL - Volume 24 IS - Supplement 1 SP - 58 EP - 59 PB - Springer CY - Berlin ER -