SPIRAL FRACTURE FIXATION TECHNIQUES - A BIOMECHANICAL STUDY

The mechanical strengths of five common fixation techniques for spiral fractures have been tested. A total of 240 cadaver metacarpals and pr oximal phalanges were fractured and fixed by either crossed K-wires, i nterosseous loops, a dorsal mini-plate, a single compression screw or K-wire plus cerclage wire. Specimens were subjected to torsional and c antilever bending tests. A single compression screw provided the best overall fixation for the proximal phalanx. In addition, a single compr ession screw provided better fixation than any of the other techniques when proximal phalanges and metacarpals were subjected to torsional t ests (P < 0.05). In apex dorsal bending tests of metacarpals, the scre w provided fixation superior to interosseous wires, crossed K-wires, o r dorsal mini-plates (P < 0.05). These results indicate that the use o f a single compression screw provides the most satisfactory biomechani cal advantage for spiral fracture fixation.