Mayo 2A Olecranon Kırık Tespitinde K-teli veya Kanüllü Vida ile Uygulanan Gergi Bantlama Metodunun Karşılaştırması: Biyomekanik Çalışma

Amaç: Bu çalışmanın amacı mayo 2A olekranon kırıklarının tedavisinde kullanılan gergi bantlama metodunun Kirschner (K)-teli veya kanüllü vida ile konfigürasyonlarının biyomekanik stabilitesini ve gücünü karşılaştırmaktı. Gereç ve Yöntemler: Çalışmada kullanılan toplam 24 anatomik ulna modeli (Sawbones Model 1004, Pacific Research Laboratories, Vashon Island, WA), K-teli ile gergi bant tespiti (Grup 1) ve kanüllü vida ile gergi bant tespiti (Grup 2) olmak üzere 12’şerli iki eşit gruba ayrıldı ve gruplar karşılaştırıldı. Mekanik karşılaştırma evrensel bir ölçüm makinesi (Shimadzu Autograph 50 kN; Shimadzu Corp) ile uygulandı. Bulgular: Fiksasyon yöntemleri karşılaştırması (K-teli/kanüllü vida), internal fiksasyonun stabilitesini ve gücünü belirleyen ana faktörlerdi. Grup 1’in ortanca fleksiyon mukavemeti 107,92 (aralık, 94,22-121,72) N ve Grup 2’nin 109,67 (aralık, 105,07-113,86) N idi. Grup 1’in ortanca varus mukavemeti ise 100,02 (aralık, 83,24-102,18) N ve Grup 2’nin 76,32 (aralık, 68,44-78,43) N idi. Varus mukavemeti ve sertliği K-teli grubunda kanüllü vida grubuna göre anlamlı şekilde daha yüksekti (her iki p değeri <0,001). Fleksiyon mukavemeti ve sertliği açısından gruplar arasında anlamlı bir farklılık saptanmadı (her iki p değeri 0,999). Sonuç: Fleksiyon bending siklik yüklenmede iki tespit arasında anlamlı bir farklılık saptanmazken, varus bending siklik yüklenmede K-teli ile uygulanan gergi bantlamada anlamlı şekilde daha stabil bir tespit sağlandı. Her iki teknikte de siklik yükleme testleri sırasında herhangi bir redüksiyon kaybı görülmedi.

Anahtar Kelimeler:

olekranon kırık fiksasyonu, gergi bantlama, deplase transvers olekranon kırığı

Comparison of Tension Band Wiring Method Applied with K-wire or Cannulated Screw in Mayo 2A Olecranon Fracture Fixation: A Biomechanical Study

Aim: The study aimed to compare the biomechanical stability and strength of the tension band wiring method used to treat mayo 2A olecranon fractures with Kirschner (K)-wire or cannulated screw configurations. Material and Methods: A total of 24 anatomical ulna models (Sawbones Model 1004, Pacific Research Laboratories, Vashon Island, WA) used in the study were divided into two equal groups of 12, tension band fixation with K-wire (Group 1) and tension band fixation with cannulated screw (Group 2), and groups were compared. The mechanical comparison was performed with a universal measuring machine (Shimadzu Autograph 50 kN; Shimadzu Corp). Results: Fixation methods comparison (K-wire/cannulated screw) were the main factors that determined the stability and the strength of the internal fixation. The median flexion strength of Group 1 was 107.92 (range, 94.22-121.72) N, and that of Group 2 was 109.67 (range, 105.07-113.86) N. The median varus strength of Group 1 was 100.02 (range, 83.24-102.18) N, and that of Group 2 was 76.32 (range, 68.44-78.43) N. Varus strength and stiffness were significantly higher in the K-wire group than in the cannulated screw group (both p values were <0.001). No significant differences were detected between the groups regarding flexion strength and stiffness (both p values were 0.999). Conclusion: Although no significant differences were detected between the two fixations in flexion bending cyclic loading, a significantly more stable fixation was achieved in tension banding applied with K-wire in varus bending cyclic loading. No reduction loss was detected during cyclic loading tests in either technique.

Keywords:

olecranon fracture fixation, tension banding, displaced transverse olecranon fractures,

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