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Finite Element Analysis of Postoperative Stability of Transverse Scaphoid Waist Fracture.
Srivastav, Ayush; Behera, Prateek; Dwivedi, Ravi Kumar; Santoshi, John Ashutosh.
Afiliación
  • Srivastav A; Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal, India.
  • Behera P; Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India.
  • Dwivedi RK; Department of Mechanical Engineering, Maulana Azad National Institute of Technology, Bhopal, India.
  • Santoshi JA; Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India.
Indian J Orthop ; 58(6): 785-793, 2024 Jun.
Article en En | MEDLINE | ID: mdl-38812856
ABSTRACT
Background and

Purpose:

Scaphoid waist fractures are often stabilised with compression screws, Kirschner wires (K-wires), or a combination of both. While clinical and bio-mechanical studies evaluating their utility are available, the ideal configuration of implant that would provide adequate stability to permit early use of the hand is debatable. We examined configurations of a single screw, one screw along with a K-wire, and two K-wires used for a transverse scaphoid waist fracture fixation aiming to assess the stability provided by each in the immediate postoperative period.

Methods:

Computer-aided design (CAD) models of the scaphoid, K-wire, and headless compression screw were created. A transverse fracture was created at the scaphoid waist, and the CAD models of the screw and K-wire were used to fix the fracture in different configurations in a distal to proximal direction. Finite Element Analysis (FEA) was used to examine the strength of configurations when they were subjected to compression and distraction forces. The total maximum deformation (TDef) and factor of safety (FoS) for each configuration were calculated and used as indirect indicators of postoperative stability.

Results:

When a single screw was used, the configurations with the screw directed posteriorly from either centre or anterior had the best combined TDef and FoS values. For one screw and one K-wire, the configuration with screw and K-wire parallel to each other with the screw located along the long axis in the AP projection and anterior to the K-wire in the lateral projection had the best combined TDef and FoS values. When using two K-wires, configurations with the two wires diverging proximally on the lateral projection had the best combined TDef and FoS values.

Conclusions:

When fixing a transverse scaphoid waist fracture with a single screw, the screw directed posteriorly from either the centre or anterior aspect of the distal pole has the best stability, a parallel configuration has the best stability when fixing it using a screw and a K-wire, and divergent configuration has the best stability when fixing it with two K-wires only.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Indian J Orthop Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Indian J Orthop Año: 2024 Tipo del documento: Article País de afiliación: India Pais de publicación: Suiza