Biomechanical effects of four different configurations in salter harris type 4 distal femoral epiphyseal fractures

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2020

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In this study, the biomechanicaleffects of four different configurations (Parallel K wires, Parallel Screw, Upper K wire-LowerScrew, Upper Screw-Lower K wire), which are used for stabilizing Salter-Harris (SH) Type 4 epiphyseal fracture of distal femurafter reduction process, on the epiphyseal plate has been investigated under axial, rotational and bendingforces in order to determinethe most advantageous configuration. The fourdifferent configurations have been modeled by using SolidWorks and computeraided numerical analyses were performed by finite element analysis software. The mesh process, boundary conditions and materialmodel have been applied in finite element analysis software for each configuration. In addition, von-Mises stress values onepiphyseal plate, screws and K wires have been calculated. There is a general near trend on stress values in all configurations onphysis line under bending (varus-valgus angulation, anterior-posterior angulation) and torsional forces in the frontal, sagittal andtransverse plane respectively. Considering the axial forces, the highest stress was found on parallel K- wires configuration in physiswhile the lowest stress was found in parallel screw configuration. It has been found particularly advantageous to use fixation typein parallel screw configuration. In addition, in SH type 4 epiphyseal fracture, fixation type is found to be disadvantageous in Kwire configuration.

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