Effect of fracture level on optimal Kirschner wire configuration in pediatric supracondylar humerus fractures: A finite element analysis


Yilmaz E. T., Dur İ. H., KABAKCI T., bulut A., Akgök B., Kolaç U. c., ...Daha Fazla

Joint diseases and related surgery, cilt.36, sa.3, ss.648-658, 2025 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 36 Sayı: 3
  • Basım Tarihi: 2025
  • Doi Numarası: 10.52312/jdrs.2025.2248
  • Dergi Adı: Joint diseases and related surgery
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), TR DİZİN (ULAKBİM)
  • Sayfa Sayıları: ss.648-658
  • Hacettepe Üniversitesi Adresli: Evet

Özet

Objectives: This study aims to evaluate the biomechanical stability of three pin configurations for transverse supracondylar humerus fractures at various levels using finite element analysis (FEA). Materials and methods: Computed tomography data from a six-year-old child were used to generate a humerus bone model. Four different fracture levels (low, transolecranon, high, and ultrahigh) and three pin fixation techniques (one lateral and one medial cross-pin [1-1M], two lateral capitellar pins [1-1C], and three lateral capitellar pins [2-1C]) were designed for the study. Translational stiffness and rotational stiffness in all directions were analyzed in the mesh models. Convergence data and stiffness data were obtained in the FEA. Results: The translational and rotational stiffness values varied across fracture levels and pin configurations. Under valgus loading, the 1-1M configuration provided the highest stability in ultrahigh fractures (3289 N/mm), while the 2-1C configuration showed superior valgus and varus stability in low and transolecranon fractures. During extension and flexion loading, the 1-1M configuration yielded the highest stiffness values for transolecranon and high fractures, while the 2-1C configuration demonstrated increased stability in low and ultrahigh fractures. For rotational loading, 1-1M produced the highest inward and outward stiffness values in low-level fractures (9175 and 11035 N·mm/degree, respectively), whereas 2-1C displayed greater rotational stiffness in ultrahigh fractures. Conclusion: This preliminary study suggests that no single pin configuration is ideal for all fracture types, and the choice should be based on the specific fracture case.