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A biomechanical study was performed to assess quantitative differences in the stability
obtained with five commonly used types of internal fixation used in proximal phalangeal
fractures. The techniques included dorsal plating, dorsal plating combined with an
interfragmentary lag screw, two interfragmentary lag screws, tension-band technique,
and crossed Kirschner wires. Rigidity and strength in apex palmar bending were determined
after oblique osteotomy and fixation of the proximal phalanx. The failure modes for
each fixation technique were also observed and described. The results showed that
both of the techniques that used interfragmentary lag screws across the oblique osteotomies
provided significantly more rigidity than did dorsal plating alone or the wired configurations
but that measurements of strength were similar between all techniques tested. Dorsal
plates were at a mechanical disadvantage on the compression surface in our apex palmar
bend test and consequently provided no more rigidity and strength than did the wired
techniques. The tension band technique represented a combination of stiff and flexible
intraosseous wires without strict application of tension band principles and provided
intermediate rigidity and strength. Rigidity and strength in intact proximal phalanges
in the controls were significantly greater than in all techniques tested.
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Article info
Publication history
Accepted:
November 5,
1985
Received:
February 22,
1985
Footnotes
+Supported in part by the American Society for Surgery of the Hand seed grant No. 84-3.
Identification
Copyright
© 1986 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
