Biomechanical analysis of distal radius fractures using intramedullary Kirschner wires

Abstract

Colles's fracture is the most common type of distal radius fracture. Surgically, it remains a challenge to restore radial height and volar tilt in order to regain optimal wrist function. Ulson's procedure provides a dynamic effect on fixing fractured fragments and restoring joint function using two wires. However, the biomechanical influences of bone and wire remain critical issues for fracture reduction and bone union in Ulson's procedure. Based on elastic beam and foundation theory, this study formulated a closed-form mathematical model to investigate the effects of bone and wire parameters on wire deflection and bony reaction. The wire deflection and bony reaction were chosen as the indices of wrist stability and reduction within the post-operative period. The predicted results showed that greater bone strength, higher wire stiffness, and longer wire contact length provide a more stable wire-bone construct, thus facilitating fracture reduction and bone union. The wire stiffness had a much more significant effect on the construct stability compared with bone quality and contact length. In terms of entry point and insertion angle, surgical planning for the contact length was more important than bony quality for stabilizing the whole wire-bone construct.