Spiral fracture fixation techniques. A biomechanical study

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Matloub HS. Jensen PL. Sanger JR. Grunert BK. Yousif NJ. Journal of Hand Surgery - British Volume. 18(4):515-9, 1993 Aug. The mechanical strengths of five common fixation techniques for spiral fractures have been tested. A total of 240 cadaver metacarpals and proximal phalanges were fractured and fixed by either crossed K-wires, interosseous loops, a dorsal mini-plate, a single compression screw or Á proximal phalanges were fractured and fixed by either crossed K-wires, Â interosseous loops, a dorsal mini-plate, a single compression screw or K-wire plus cerclage wire. Specimens were subjected to torsional and cantilever bending tests. A single compression screw provided the best overall fixation for the proximal phalanx. In addition, a single compression screw provided better fixation than any of the other techniques when proximal phalanges and metacarpals were subjected to torsional tests (P < 0.05). In apex dorsal bending tests of metacarpals, the screw provided fixation superior to interosseous wires, crossed K-wires, or dorsal mini-plates (P < 0.05). These results indicate that the use of a single compression screw provides the most satisfactory biomechanical advantage for spiral fracture fixation. *