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Comparison of Tension Band Wiring Method Applied with K-wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study

Year 2022, Volume: 24 Issue: 2, 152 - 156, 30.08.2022

Murat Kaya Fatih Ertem

https://doi.org/10.18678/dtfd.1093651

Abstract

Aim: The study aimed to compare the biomechanical stability and strength of the tension band wiring method used to treat mayo 2A olecranon fractures with Kirschner (K)-wire or cannulated screw configurations.
Material and Methods: A total of 24 anatomical ulna models (Sawbones Model 1004, Pacific Research Laboratories, Vashon Island, WA) used in the study were divided into two equal groups of 12, tension band fixation with K-wire (Group 1) and tension band fixation with cannulated screw (Group 2), and groups were compared. The mechanical comparison was performed with a universal measuring machine (Shimadzu Autograph 50 kN; Shimadzu Corp).
Results: Fixation methods comparison (K-wire/cannulated screw) were the main factors that determined the stability and the strength of the internal fixation. The median flexion strength of Group 1 was 107.92 (range, 94.22-121.72) N, and that of Group 2 was 109.67 (range, 105.07-113.86) N. The median varus strength of Group 1 was 100.02 (range, 83.24-102.18) N, and that of Group 2 was 76.32 (range, 68.44-78.43) N. Varus strength and stiffness were significantly higher in the K-wire group than in the cannulated screw group (both p values were <0.001). No significant differences were detected between the groups regarding flexion strength and stiffness (both p values were 0.999).
Conclusion: Although no significant differences were detected between the two fixations in flexion bending cyclic loading, a significantly more stable fixation was achieved in tension banding applied with K-wire in varus bending cyclic loading. No reduction loss was detected during cyclic loading tests in either technique.

Keywords

olecranon fracture fixation tension banding displaced transverse olecranon fractures

References

  • Veillette CJ, Steinmann SP. Olecranon fractures. Orthop Clin North Am. 2008;39(2):229-36.
  • Powell AJ, Farhan-Alanie OM, Bryceland JK, Nunn T. The treatment of olecranon fractures in adults. Musculoskelet Surg. 2017;101(1):1-9.
  • Newman SD, Mauffrey C, Krikler S. Olecranon fractures. Injury. 2009;40(6):575-81.
  • Chalidis BE, Sachinis NC, Samoladas EP, Dimitriou CG, Pournaras JD. Is tension band wiring technique the "gold standard" for the treatment of olecranon fractures? A long term functional outcome study. J Orthop Surg Res. 2008;3:9.
  • Rantalaiho IK, Miikkulainen AE, Laaksonen IE, Äärimaa VO, Laimi KA. Treatment of displaced olecranon fractures: a systematic review. Scand J Surg. 2021;110(1):13-21.
  • Claessen FM, Braun Y, Peters RM, Dyer G, Doornberg JN, Ring D. Factors associated with reoperation after fixation of displaced olecranon fractures. Clin Orthop Relat Res. 2016;474(1):193-200.
  • Carter TH, Molyneux SG, Reid JT, White TO, Duckworth AD. Tension-band wire fixation of olecranon fractures. JBJS Essent Surg Tech. 2018;8(3):e22.
  • Parker JR, Conroy J, Campbell DA. Anterior interosseus nerve injury following tension band wiring of the olecranon. Injury. 2005;36(10):1252-3.
  • Shimura H, Nimura A, Fujita K, Kaburagi H. Comparison of the efficacy of the tension band wiring with eyelet wire versus anatomical locking plate fixation for the treatment of displaced olecranon fractures. J Orthop Surg (Hong Kong). 2021;29(3):23094990211059231.
  • Snoddy MC, Lang MF, An TJ, Mitchell PM, Grantham WJ, Hooe BS, et al. Olecranon fractures: factors influencing re-operation. Int Orthop. 2014;38(8):1711-6.
  • Chan KW, Donnelly KJ. Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate? J Orthop. 2015;12(2):111-7.
  • Midtgaard KS, Frihagen F, Dornan GJ, Coucheron M, Fossåen C, Grundel D, et al. Predicting secondary surgery after operative fixation of olecranon fractures: a model using data from 800 patients. JSES Int. 2021;5(5):948-53.
  • Lu QF, Tang GL, Zhao XJ, Zhang WJ, Guo SG, Wang HZ. Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study. Acta Orthop Traumatol Turc. 2015;49(6):654-60.
  • Mullett JH, Shannon F, Noel J, Lawlor G, Lee TC, O’Rourke SK. K-wire position in tension band wiring of the olecranon-a comparison of two techniques. Injury. 2000;31(6):427-31.
  • Wang W, Wu G, Shen F, Zhang Y, Liu X. A biomechanical experiment and clinical study of the use of figure of eight plus circular wiring fixation for the treatment of olecranon fractures. Exp Ther Med. 2012;4(6):1081-6.
  • Jones TB, Karenz AR, Weinhold PS, Dahners LE. Transcortical screw fixation of the olecranon shows equivalent strength and improved stability compared with tension band fixation. J Orthop Trauma. 2014;28(3):137-42.
  • Hutchinson DT, Horwitz DS, Ha G, Thomas CW, Bachus KN. Cyclic loading of olecranon fracture fixation constructs. J Bone Joint Surg Am. 2003;85(5):831-7.
  • Carofino BC, Santangelo SA, Kabadi M, Mazzocca AD, Browner BD. Olecranon fractures repaired with FiberWire or metal wire tension banding: a biomechanical comparison. Arthroscopy. 2007;23(9):964-70.
  • Acevedo JI, Sammarco VJ, Boucher HR, Parks BG, Schon LC, Myerson MS. Mechanical comparison of cyclic loading in five different first metatarsal shaft osteotomies. Foot Ankle Int. 2002;23(8):711-6.
  • Kılıç B, Çalışkan M, Agar A, Uzun B, Ertem F, Gülabi D, et al. Comparison of two different screw trajectories in the treatment of oblique scaphoid fractures: A mechanical study on composite bone models. Jt Dis Relat Surg. 2021;32(2):377-82.

Mayo 2A Olecranon Kırık Tespitinde K-teli veya Kanüllü Vida ile Uygulanan Gergi Bantlama Metodunun Karşılaştırması: Biyomekanik Çalışma

Year 2022, Volume: 24 Issue: 2, 152 - 156, 30.08.2022

Murat Kaya Fatih Ertem

https://doi.org/10.18678/dtfd.1093651

Abstract

Amaç: Bu çalışmanın amacı mayo 2A olekranon kırıklarının tedavisinde kullanılan gergi bantlama metodunun Kirschner (K)-teli veya kanüllü vida ile konfigürasyonlarının biyomekanik stabilitesini ve gücünü karşılaştırmaktı.
Gereç ve Yöntemler: Çalışmada kullanılan toplam 24 anatomik ulna modeli (Sawbones Model 1004, Pacific Research Laboratories, Vashon Island, WA), K-teli ile gergi bant tespiti (Grup 1) ve kanüllü vida ile gergi bant tespiti (Grup 2) olmak üzere 12’şerli iki eşit gruba ayrıldı ve gruplar karşılaştırıldı. Mekanik karşılaştırma evrensel bir ölçüm makinesi (Shimadzu Autograph 50 kN; Shimadzu Corp) ile uygulandı.
Bulgular: Fiksasyon yöntemleri karşılaştırması (K-teli/kanüllü vida), internal fiksasyonun stabilitesini ve gücünü belirleyen ana faktörlerdi. Grup 1’in ortanca fleksiyon mukavemeti 107,92 (aralık, 94,22-121,72) N ve Grup 2’nin 109,67 (aralık, 105,07-113,86) N idi. Grup 1’in ortanca varus mukavemeti ise 100,02 (aralık, 83,24-102,18) N ve Grup 2’nin 76,32 (aralık, 68,44-78,43) N idi. Varus mukavemeti ve sertliği K-teli grubunda kanüllü vida grubuna göre anlamlı şekilde daha yüksekti (her iki p değeri <0,001). Fleksiyon mukavemeti ve sertliği açısından gruplar arasında anlamlı bir farklılık saptanmadı (her iki p değeri 0,999).
Sonuç: Fleksiyon bending siklik yüklenmede iki tespit arasında anlamlı bir farklılık saptanmazken, varus bending siklik yüklenmede K-teli ile uygulanan gergi bantlamada anlamlı şekilde daha stabil bir tespit sağlandı. Her iki teknikte de siklik yükleme testleri sırasında herhangi bir redüksiyon kaybı görülmedi.

Keywords

olekranon kırık fiksasyonu gergi bantlama deplase transvers olekranon kırığı

References

  • Veillette CJ, Steinmann SP. Olecranon fractures. Orthop Clin North Am. 2008;39(2):229-36.
  • Powell AJ, Farhan-Alanie OM, Bryceland JK, Nunn T. The treatment of olecranon fractures in adults. Musculoskelet Surg. 2017;101(1):1-9.
  • Newman SD, Mauffrey C, Krikler S. Olecranon fractures. Injury. 2009;40(6):575-81.
  • Chalidis BE, Sachinis NC, Samoladas EP, Dimitriou CG, Pournaras JD. Is tension band wiring technique the "gold standard" for the treatment of olecranon fractures? A long term functional outcome study. J Orthop Surg Res. 2008;3:9.
  • Rantalaiho IK, Miikkulainen AE, Laaksonen IE, Äärimaa VO, Laimi KA. Treatment of displaced olecranon fractures: a systematic review. Scand J Surg. 2021;110(1):13-21.
  • Claessen FM, Braun Y, Peters RM, Dyer G, Doornberg JN, Ring D. Factors associated with reoperation after fixation of displaced olecranon fractures. Clin Orthop Relat Res. 2016;474(1):193-200.
  • Carter TH, Molyneux SG, Reid JT, White TO, Duckworth AD. Tension-band wire fixation of olecranon fractures. JBJS Essent Surg Tech. 2018;8(3):e22.
  • Parker JR, Conroy J, Campbell DA. Anterior interosseus nerve injury following tension band wiring of the olecranon. Injury. 2005;36(10):1252-3.
  • Shimura H, Nimura A, Fujita K, Kaburagi H. Comparison of the efficacy of the tension band wiring with eyelet wire versus anatomical locking plate fixation for the treatment of displaced olecranon fractures. J Orthop Surg (Hong Kong). 2021;29(3):23094990211059231.
  • Snoddy MC, Lang MF, An TJ, Mitchell PM, Grantham WJ, Hooe BS, et al. Olecranon fractures: factors influencing re-operation. Int Orthop. 2014;38(8):1711-6.
  • Chan KW, Donnelly KJ. Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate? J Orthop. 2015;12(2):111-7.
  • Midtgaard KS, Frihagen F, Dornan GJ, Coucheron M, Fossåen C, Grundel D, et al. Predicting secondary surgery after operative fixation of olecranon fractures: a model using data from 800 patients. JSES Int. 2021;5(5):948-53.
  • Lu QF, Tang GL, Zhao XJ, Zhang WJ, Guo SG, Wang HZ. Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study. Acta Orthop Traumatol Turc. 2015;49(6):654-60.
  • Mullett JH, Shannon F, Noel J, Lawlor G, Lee TC, O’Rourke SK. K-wire position in tension band wiring of the olecranon-a comparison of two techniques. Injury. 2000;31(6):427-31.
  • Wang W, Wu G, Shen F, Zhang Y, Liu X. A biomechanical experiment and clinical study of the use of figure of eight plus circular wiring fixation for the treatment of olecranon fractures. Exp Ther Med. 2012;4(6):1081-6.
  • Jones TB, Karenz AR, Weinhold PS, Dahners LE. Transcortical screw fixation of the olecranon shows equivalent strength and improved stability compared with tension band fixation. J Orthop Trauma. 2014;28(3):137-42.
  • Hutchinson DT, Horwitz DS, Ha G, Thomas CW, Bachus KN. Cyclic loading of olecranon fracture fixation constructs. J Bone Joint Surg Am. 2003;85(5):831-7.
  • Carofino BC, Santangelo SA, Kabadi M, Mazzocca AD, Browner BD. Olecranon fractures repaired with FiberWire or metal wire tension banding: a biomechanical comparison. Arthroscopy. 2007;23(9):964-70.
  • Acevedo JI, Sammarco VJ, Boucher HR, Parks BG, Schon LC, Myerson MS. Mechanical comparison of cyclic loading in five different first metatarsal shaft osteotomies. Foot Ankle Int. 2002;23(8):711-6.
  • Kılıç B, Çalışkan M, Agar A, Uzun B, Ertem F, Gülabi D, et al. Comparison of two different screw trajectories in the treatment of oblique scaphoid fractures: A mechanical study on composite bone models. Jt Dis Relat Surg. 2021;32(2):377-82.
There are 20 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Murat Kaya 0000-0001-8751-9603

Fatih Ertem 0000-0002-3003-3001

Publication Date August 30, 2022
Submission Date March 27, 2022
Published in Issue Year 2022 Volume: 24 Issue: 2

Cite

APA Kaya, M., & Ertem, F. (2022). Comparison of Tension Band Wiring Method Applied with K-wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study. Duzce Medical Journal, 24(2), 152-156. https://doi.org/10.18678/dtfd.1093651
AMA Kaya M, Ertem F. Comparison of Tension Band Wiring Method Applied with K-wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study. Duzce Med J. August 2022;24(2):152-156. doi:10.18678/dtfd.1093651
Chicago Kaya, Murat, and Fatih Ertem. “Comparison of Tension Band Wiring Method Applied With K-Wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study”. Duzce Medical Journal 24, no. 2 (August 2022): 152-56. https://doi.org/10.18678/dtfd.1093651.
EndNote Kaya M, Ertem F (August 1, 2022) Comparison of Tension Band Wiring Method Applied with K-wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study. Duzce Medical Journal 24 2 152–156.
IEEE M. Kaya and F. Ertem, “Comparison of Tension Band Wiring Method Applied with K-wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study”, Duzce Med J, vol. 24, no. 2, pp. 152–156, 2022, doi: 10.18678/dtfd.1093651.
ISNAD Kaya, Murat - Ertem, Fatih. “Comparison of Tension Band Wiring Method Applied With K-Wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study”. Duzce Medical Journal 24/2 (August 2022), 152-156. https://doi.org/10.18678/dtfd.1093651.
JAMA Kaya M, Ertem F. Comparison of Tension Band Wiring Method Applied with K-wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study. Duzce Med J. 2022;24:152–156.
MLA Kaya, Murat and Fatih Ertem. “Comparison of Tension Band Wiring Method Applied With K-Wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study”. Duzce Medical Journal, vol. 24, no. 2, 2022, pp. 152-6, doi:10.18678/dtfd.1093651.
Vancouver Kaya M, Ertem F. Comparison of Tension Band Wiring Method Applied with K-wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study. Duzce Med J. 2022;24(2):152-6.
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