This paper is only available as a PDF. To read, Please Download here.
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.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Hand Surgery
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Fractures of the shafts of the phalanges of the hand.Hand. 1981; 11: 119-133
- Physiological fixation of displaced and unstable fractures of the hand.Orthop Clin North Am. 1980; 11: 393-404
- The management of phalangeal and metacarpal fractures.Surg Clin North Am. 1973; 53: 1393-1437
- Small fragment set manual. Springer-Verlag, Berlin1982
- The place of internal skeletal fixation in surgery of the hand.Clin Plast Surg. 1981; 8: 51-64
- Development of new methods for phalangeal fracture fixation.J Biomechanics. 1981; 14: 377-387
- Comparison of internal fixation techniques in metacarpal fractures.J Hand Surd. 1985; 10A: 466-472
- The mechanical stability of internal fixation of fractured phalanges.Hand. 1979; 11: 50-54
- Tension band stabilities of transverse fractures: an Experimental analysis.Plast Reconstr Surg. 1984; 73: 111-116
- Comparison of rigidity of whole tubular bones.J Biomechanics. 1979; 12: 367-372
- A phalangeal fracture model-quantitative analysis of rigidity and failure.J Hand Surg. 1982; 7: 264-279
- Mechanical analysis of Kirschner wire fixation in a phalangeal model.J Hand Surg. 1979; 4: 351-356
- A strain recording model: analysis of transverse osteotomy fixation in small bones.J Hand Surg. 1984; 9A: 383-387
- The comparative strengths of internal fixation techniques.J Hand Surg. 1984; 9A: 216-221
- Biomechanical characteristics of bone.Adv Biomed Eng. 1971; 1: 137-187
- Intraosseous wiring of the digital skeleton.J Hand Surg. 1978; 3: 427-435
Accepted: November 5, 1985
Received: February 22, 1985
+Supported in part by the American Society for Surgery of the Hand seed grant No. 84-3.
© 1986 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.