Tension band wire fixation for valgus osteotomies of the proximal femur: a biomechanical study of three configurations of fixation

Clinical Biomechanics
J B VolponCarlos Alberto Moro

Abstract

A variety of techniques can be used to achieve stabilization of femoral valgus osteotomies in children, but what is lacking is a versatile fixation system that associates stability and versatility at different ages and for different degrees of deformity. Mechanical tests of three configurations used to fix femoral valgus osteotomies, based on the tension band wire principle, were carried out. A 30 degrees wedge valgus osteotomy was performed at the subtrochanteric level in 60 swine femurs and fixed with three different systems. In Group 1, two Kirschner wires (K wire) were introduced from the tip of the greater trochanter to the medial cortex, crossing the osteotomy. A flexible steel wire was anchored to the K wires into holes in the lateral cortex and tightened to form a tension band. The same setup was used in Group 2, but two additional smooth K wires were inserted into the lateral surface of the greater trochanter and driven to the femoral head with the distal extremities bent and tied around the bone shaft. In Group 3, the fixation was similar to that in Group 2, but the ascending K wires were introduced below the osteotomy level, crossing the osteotomy. Mechanical tests in bending-compression and torsion were used to acce...Continue Reading

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Citations

Mar 10, 2011·Archives of Orthopaedic and Trauma Surgery·Gabriel J HommelJohn V Marymont
Jul 31, 2013·Current Reviews in Musculoskeletal Medicine·Michael D HellmanShane J Nho
Aug 8, 2014·Medicine·Daniel Augusto MaranhoJosé Batista Volpon
Sep 4, 2014·Current Reviews in Musculoskeletal Medicine·Alessandro ApratoAlessandro Masse
Apr 2, 2015·Surgical and Radiologic Anatomy : SRA·Martin BeckS Kohl
Jul 14, 2017·Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology·Ahmed Shawkat Rizk

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