Özcan PEHLİVAN, SUAT YILMAZ, Ahmet KIRAL, İbrahim AKMAZ, Mahir MAHİROĞULLARI, Haluk KAPLAN

Transvers osteotomilerde K-teli konfigürasyonlarının dört nokta eğme testi ile deneysel olarak karşılaştırılması

Amaç: Elin tübüler kemiklerinin instabil transvers kırıklarının cerrahi fiksasyonunda sık kullanılan bazı yöntemler, tavuk kanadının humerus kemiğinde oluşturulan transvers osteotomilerde uygulandıktan sonra dört nokta eğme testi ile biyomekanik sağlamlıkları karşılaştırıldı. Çalışma planı: Otuz adet tavuk humerus kemiği her biri beş kemikten oluşan altı guruba ayrılarak transvers osteotomi uygulandı. Her bir grupta iki adet K-teli ile farklı konfigürasyonlarla sağlanan fiksasyonun laboratuvar ortamında dört nokta eğme testinde eğilme rijiditeleri ölçüldü. İki ayrı kalınlıkta K-teli kullanılarak, iki grupta intramedüller, iki grupta çapraz, iki grupta ise çapraz K-teli fiksasyonuna ek olarak tension band wiring tekniği kullanıldı. Elde edilen sonuçlar istatistiksel olarak değerlendirildi. Sonuçlar: En yüksek rijidite 0.045 inch'lik, ondan sonra da 0.035 inch'lik çapraz K-telleri ile birlikte uygulanan tension band wiring tekniği ile elde edildi; bu uygulamaları n, tek başına uygulanan çapraz ve intramedüller K-teli fiksasyonlarına göre anlamlı derecede daha rijid bir fiksasyon sağladıkları görüldü. Çıkarımlar: Elin tübüler kemiklerindeki transvers kırıklarda, çapraz K-teli uygulamasıyla beraber dorsalden uygulanacak tension band wiring tekniği ile ameliyat sonrası dönemde erken hareket vermeye olanak sağlayacak sağlamlıkta bir fiksasyon elde etmek mümkün olabilir.

Anahtar Kelimeler:

Kırık tespiti, internal, Humerus kırıkları, Osteotomi, Biyomekanik, Kemik telleri, Tavuklar

Evaluation of biomechanical rigidity of K-wire configurations in transverse osteotomies: A comparison of four-point bending test results

Objectives: Four-point bending test was performed in transverse osteotomies of chicken humerus in order to assess biomechanical rigidity of fixation techniques that are commonly used in transverse unstable fractures of the tubular bones of the hand. Methods: Thirty chicken humeral bones were transversely osteotomized and then randomly assigned to six fixation groups equal in number. Osteotomized bones were fixed with the use of two crossed (2 groups) or intramedullary (2 groups) K-wires; in the remaining two groups, crossed K-wires were used in combination with tension band wiring. The sizes of the crossed and intramedullary K-wires were 0.035-inch and 0.045-inch in paired groups, respectively. Biomechanical rigidity was measured by four-point bending test on an Instron testing machine. Results: The most rigid configuration was obtained with 0.045-inch K-wires, followed by 0.035-inch K-wires used in combination with tension band wiring. These techniques provided significantly increased rigid fixations than those obtained by non-supplemented crossed and intramedullary K-wire fixations. Conclusion: In the transverse fractures of the tubular bones of the hand, dorsally applied tension band wiring around two crossed K-wires provides adequate rigidity that allows early active motion in the postoperative period.

Keywords:

Fracture Fixation, Internal, Humeral Fractures, Osteotomy, Biomechanics, Bone Wires, Chickens,

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