Interference Kirschner wires augment distal humeral fracture fixation in the elderly

J Orthop Trauma. 2005 Jul;19(6):377-9. doi: 10.1097/01.bot.0000157909.30692.8c.

Abstract

Objectives: This study was designed to compare the biomechanical stability of a two-plate distal humerus fixation with and without Kirschner-wire (K-wire) augmentation of supracondylar osteotomies.

Design: Ex vivo paired cadaveric study.

Setting: Biomechanical laboratory.

Materials: : Five pairs of fresh, elderly cadaveric humeri.

Intervention: Two 3.5-mm reconstruction plates were used to stabilize each humerus. This fixation model was selected solely to evaluate the effect of K-wire augmentation. Augmentation consisted of 2 K-wires placed in both the medial and lateral columns of the humerus to interdigitate with the plate screws. A posteriorly directed load was cyclically applied to the distal fragment for 5000 cycles or until failure, and osteotomy site motion was tracked optically.

Main outcome measurements: Fixation survival was defined as 5000 cycles or the number of cycles until osteotomy site motion reached >2 mm.

Results: K-wire augmented fixations survived significantly more cycles than did controls (4410 +/- 875 vs. 1114 +/- 2182, respectively; paired t test, P < 0.05).

Conclusions: Augmentation with K-wires may decrease the incidence of loss of fixation in distal humeral fractures.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biomechanical Phenomena
  • Bone Plates
  • Bone Wires*
  • Cadaver
  • Equipment Failure Analysis
  • Female
  • Fracture Fixation, Internal / instrumentation*
  • Humans
  • Humeral Fractures / physiopathology
  • Humeral Fractures / surgery*
  • Male
  • Osteotomy