Effects of Different Fixation Methods on Stability for Distal Tibial Epiphyseal Injuries in Children
10.16156/j.1004-7220.2025.03.026
- VernacularTitle:不同固定方式对儿童胫骨远端骨骺损伤的稳定性影响
- Author:
Xiaoming WANG
1
;
Zhe TUO
1
;
Xing TONG
1
;
Ming YANG
1
;
Hailiang MENG
1
;
Chenxin LIU
1
;
Bing WANG
1
Author Information
1. 西安交通大学附属红会医院儿童病医院综合病区,西安 710054
- Publication Type:Journal Article
- Keywords:
pediatric fractures;
epiphyseal injury;
screw fixation;
Kischner wire fixation;
biomechancial stability
- From:
Journal of Medical Biomechanics
2025;40(3):713-718,748
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the the effects of fracture fragment size and fixation method on biomechanical stability of distal tibial epiphyseal injuries in children.Methods A three-dimensional(3D)finite element model of a Salter-Harris Ⅱ(SH-Ⅱ)epiphyseal injury with fracture fragments of varying sizes(Small,Middle,Big)was constructed using computed tomography(CT)data from the lower limb of a 10-year-old volunteer.and bone-internal fixation assemblies were created with 1-3 screws(1 S group,2 S group,3 S group)and Kirschner wire(K group).The model was subjected to gravitational forces,posterior drawer forces,and external rotation.Displacement and stress distributions on fracture fragments and fixation devices were analyzed.Results The maximum displacement for the four groups of models was concentrated at the distal end of the fracture fragment.Under gravity conditions,the maximum displacement of the distal end of the fracture fragment in the 1 S,2 S,3 S and K models in Small group was 5.69,5.57,5.56,0.11 mm,respectively,and the bone stress was 16.95,12.26,8.57 and 5.00 MPa,respectively.A high stress area at the epiphyseal plate and the fracture line was easily formed under screw fixation,while a high stress area at the edge of the epiphyseal plate was formed under Kirschner wire fixation.Conclusions When distal tibial epiphyseal injuries in children are treated by using screws,increasing the number of screws can improve the fixation stability and share local bone stress,but the connection area between the fracture fragment and the epiphyseal plate cannot be too small.Kirschner wire fixation can provide better biomechanical effects than screw fixation.
