Reconstruction of radial capitellar fractures using fine-threaded implants (FFS)

Heck, Steffen; Zilleken, Christian; Pennig, D.; Koslowsky, Thomas C.

doi:10.1016/j.injury.2011.04.009

Cited by 39 publications

(46 citation statements)

References 19 publications

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“…A wide variety of implants have been used to fix the capitellum, ranging from K-wires to headless screws21 27–32 to absorbable implants1 and fine-threaded implants 33. Herbert screws are widely used as it can be buried underneath the cartilage in subchondral bone 23.…”

Section: Discussionmentioning

confidence: 99%

Corrective osteotomy through fracture site and internal fixation with headless screws for type I (Hahn-Steinthal) capitellar malunion

2013

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A 20-year-old woman presented 6 months after an initial injury to her left elbow with pain and restricted movements. She was diagnosed with a type I malunited (Hahn-Steinthal) type of capitellum fracture through radiographic studies. Classically, the treatment has been excision of the fragment, which carries a risk of valgus instability of the elbow and late osteoarthrosis. We report a case of malunited type I capitellum fracture, for which corrective osteotomy through fracture site, open reduction and internal fixation was done 6 months following missed trauma. At 24 months follow-up the capitellum fracture had united and the patient has a stable elbow and excellent range of motion. Our case demonstrates that for type I malunited capitellum fractures corrective osteotomy through fracture site and internal fixation rather than excision of the fragment in young can result in successful union and stable elbow.

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Section: Discussionmentioning

confidence: 99%

Corrective osteotomy through fracture site and internal fixation with headless screws for type I (Hahn-Steinthal) capitellar malunion

2013

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“…The FFS was designed as a 1-step fixation system for the treatment of small fracture fragments. [13][14][15][16][17] These implants are inserted without predrilling or tapping and have an autocompression effect on bone fragments. [34][35][36] In recent biomechanical studies, the FFS has displayed substantial pullout strength and a comparable resistance to offset axial load when compared with partially threaded cancellous screws in medial malleolus fractures, 37 as well as better reduction and stability than the mini-plate in Mason type III fractures.…”

Section: Discussionmentioning

confidence: 99%

“…The FFS has since successfully been used in the clinical setting for small-fragment fixation in various fractures, such as medial malleolus, metatarsal, radial head, capitulum humeri, and olecranon fractures. [13][14][15][16][17] Despite the encouraging results observed in other sites, no previous studies have analyzed the clinical results of the FFS in coronoid osteosynthesis. In the current study, the authors obtained satisfactory clinical results for the majority of patients using the FFS.…”

Section: Discussionmentioning

confidence: 99%

“…The goal of this prospective study was to analyze the results yielded by an alternative fracture fixation technique consisting of the insertion of fine-threaded Kwires (Fragment Fixation System [FFS]; Orthofix, Bussolengo, Italy). These devices have been successfully used in smallfragment fixation in other joints, as well as in capitulum humeri, radial head, and olecranon fractures [13][14][15][16][17] ; however, no information is available on their use in coronoid fixation. The authors hypothesized that the FFS is an easy, minimally invasive, and stable 1-step fixation technique that may be helpful in the management of these difficult fractures.…”

Section: Figurementioning

confidence: 99%

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Use of Fine-threaded K-wires in the Treatment of Coronoid Fractures in Complex Elbow Instability

Giannicola¹,

Polimanti²,

Gumina³

et al. 2013

Orthopedics

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The coronoid process is one of the main elbow constraints that provides ulnohumeral joint stability. Coronoid fractures may be fixed using multiple techniques, including transosseous sutures, screws, and plates. The goal of this study was to analyze the clinical and radiographic outcomes in a series of patients with complex elbow instability in whom coronoid fractures were repaired using fine-threaded K-wires. Eight men and 10 women (mean age, 47 years) were followed prospectively for a mean of 26 months. Surgical treatment consisted of open reduction and internal fixation of all fractures; radial head replacement in Mason III injuries; lateral collateral ligament repair in all patients; and, in cases of persistent instability, medial collateral ligament repair, hinged fixator application, or both. Coronoid fixation was performed using 2 or more fine-threaded K-wires, depending on the fragment size, inserted from the posterior aspect of the ulna and directed toward the coronoid fragment using a 1-step fixation technique. At last follow-up, mean extension was 15°, mean flexion was 133°, mean pronation was 78°, and mean supination was 69°; mean Disabilities of the Arm, Shoulder and Hand score was 9.7, mean American Shoulder and Elbow Surgeons score was 85, and mean Mayo Elbow Performance Score was 89. According to the Mayo Elbow Performance Index, 10 excellent, 7 good, and 1 fair result were recorded. All but 1 patient had a stable elbow. Fracture healing was observed in all but 1 patient. No secondary coronoid fragment dislocation or implant failures were reported. This study shows that using fine-threaded K-wires provides easy, minimally invasive, stable, and successful 1-step fixation that can be used to obtain osteosynthesis of coronoid fractures in patients with complex elbow instability.

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“…They speculate that using screws can achieve stable fixation and provide compression across the fracture and that internal fixation by Kirschner wires (K‐wires) is not desirable because it does not bring compression at the fracture site and has higher incidence of complications such as loosening and failure . However, several studies report that the elbow joint function is satisfactory after using K‐wires as treatment of capitellar and trochlear fractures . Given the rare incidence of such fractures, it is difficult to compare the effects of screw fixation and K‐wire fixation on functional recovery of the elbow joint.…”

Section: Introductionmentioning

confidence: 99%

Combined use of Kirschner wires and hinged external fixator for capitellar and trochlear fractures: a minimum 24‐month follow‐up

Zhao

Guo

et al. 2018

ANZ Journal of Surgery

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Background: Open reduction and internal fixation is the adequate treatment for capitellar and trochlear fractures. Given the low incidence of this type of fractures, it is difficult to constitute a universally accepted method for fixation. Thus, we hypothesised that combined use of Kirschner wires (K-wires), absorbable rods and sutures for fixation and post-operative hinged external fixator for early rehabilitation exercise can restore elbow joint function well. Methods: This retrospective study included 20 patients with a mean age of 48.3 (range 16-76) years. According to the Dubberley classification, fractures were classified on plain radiographs, computed tomography images and intra-operative findings. All patients were evaluated by the range of motion of the elbow and the Broberg-Morrey score. Results: All fractures had healed without non-union, and the average time was 13.6 (range 8-17) weeks. The mean follow-up was 42.5 (range 24-80) months. The mean flexion was 117.1 (range 90 -135 ), and the mean extension was 17.5 (range 0 -45 ). The mean pronation was 74.4 (range 45 -85 ), and the mean supination was 84.3 (range 60 -90 ). The average Broberg-Morrey score was 86.2 (range 68-98) points with 10 excellent, 7 good and 3 fair results. Conclusion: K-wires, absorbable rods and sutures combined with hinged external fixator are feasible for fixation of capitellar and trochlear fractures. However, due to the absence of a control group (such as Herbert screw fixation), comparative studies are still needed to demonstrate the safety and reliability of K-wires for fixation.

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Reconstruction of radial capitellar fractures using fine-threaded implants (FFS)

Cited by 39 publications

References 19 publications

Corrective osteotomy through fracture site and internal fixation with headless screws for type I (Hahn-Steinthal) capitellar malunion

Corrective osteotomy through fracture site and internal fixation with headless screws for type I (Hahn-Steinthal) capitellar malunion

Use of Fine-threaded K-wires in the Treatment of Coronoid Fractures in Complex Elbow Instability

Combined use of Kirschner wires and hinged external fixator for capitellar and trochlear fractures: a minimum 24‐month follow‐up

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