Biomechanical analysis of different osteosynthesis configurations in the pin and plate fixation method for distal humerus fractures

• Published in: BMC musculoskeletal disorders 2023-07, Vol.24 (1), p.579-579, Article 579
• Main Authors: Hakiminejad, Alireza, Nourani, Amir, Ghias, Narges, Mahmoudi, Alireza, Same, Kaveh, Kamrani, Reza Shahriar, Nabian, Mohammad Hossein
• Format: Article
• Language: English
• Subjects: Biomechanical Phenomena; Biomechanical testing; Biomechanics; Bone mineral density; Bone Plates; Bone surgery; Cadavers; Clinical outcomes; Design of experiments; Distal humerus fracture; Fracture Fixation, Internal - methods; Fractures; Humans; Humeral Fractures - surgery; Humeral Fractures, Distal; Humerus; Mathematical models; Mechanical loading; Methods; Musculoskeletal diseases; Orthopedics; Osteosynthesis; Persian fixation method; Simulation; Stability; Surgeons
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-023-06709-y

Distal humerus fractures commonly occur in adults with low bone mineral density causing major technical challenges for orthopedic surgeons. Persian fixation method was introduced as a novel technique to stabilize small fragments in comminuted distal humerus fractures using a set of K-wires and a reconstruction plate. The present study aims to measure this technique's stiffness and stability of this technique and analyze the effect of influential parameters with numerical simulation and biomechanical testing on a cadaveric specimen. Validation of the finite element (FE) model was conducted based on results of experiments. The results indicated that Delta configuration mainly led to a higher stiffness in the case of axial loading and anterior bending compared to L configuration. Analyzing the influential factors of this technique suggests that changes in diameter and number of K-wires have a similarly significant effect on the construct stiffness while the height of plate had a slight influence. Also, the diameter of wires was the most effective parameter for implant failure, particularly in the 3-pin construct, which caused a reduction in failure risk by about 60%. The results revealed that the Persian fixation method would achieve suitable stability compared to the dual-plating technique.