Finite element analysis of two fixation methods for Salter-Harris type II distal radius epiphyseal fracture in children

doi:10.12307/2026.222

Abstract

Abstract: BACKGROUND: There is controversy over the selection of treatment options for pediatric distal radius epiphyseal fractures, and there is a lack of theory in biomechanical performance between Kirschner wire internal fixation and splint external fixation in terms of stability.
OBJECTIVE: To explore the biomechanical characteristics of external fixation with splints and internal fixation with Kirschner wires in the treatment of Salter-Harris type II distal radial epiphyseal fractures in children through finite element experiments.
METHODS: Based on CT data of children's wrist joint, Salter-Harris type II distal radius epiphyseal fracture was simulated, and model A was established. On this basis, two different fixation methods were established: model B, Kirschner wire cross internal fixation (2 Kirschner wires); Model C, externally fixed with 4 clamps. Loads were applied to the model to simulate the displacement and stress distribution of the distal fracture end and the distal radioulnar joint of the wrist joint under axial pressure combined with pronation and supination conditions.
RESULTS AND CONCLUSION: (1) Model A has the highest displacement peak area and stress peak displacement degree in the vertical pressure combined pre rotation and post rotation motion states. The maximum stress and relative displacement values between the distal radius fracture end and the distal radioulnar joint are the highest. (2) Compared with Model C, Model B has a smaller maximum stress and displacement value, and the peak area of the displacement cloud map has also decreased. The peak area of the stress cloud map has shifted back towards the center. There is no significant difference in the percentage difference in the maximum stress and displacement values between Models B and C and Model A, indicating that the two fixing methods have similar effects on alleviating relative displacement and structural stress. (3) The results showed that Kirschner wire internal fixation and splint external fixation can effectively maintain the stability of the distal fracture end and the distal radioulnar joint. The splint, as an external fixation device and Kirschner wire internal fixation, showed similar fixation effects on Salter-Harris type II distal radial epiphyseal fractures.

Key words: radius, fracture, epiphysis, splint, Kirschner wire, external fixation, internal fixation, finite element analysis

CLC Number:

Zhou Yunfan, Meng Xiangqi, Shen Chenxiao. Finite element analysis of two fixation methods for Salter-Harris type II distal radius epiphyseal fracture in children[J]. Chinese Journal of Tissue Engineering Research, 2026, 30(27): 7009-7014.

Figures/Tables 4

2.1 各工况下下尺桡关节的相对位移与应力变化情况模型B和模型C尺桡关节在两种工况下的最大应力值与最大位移值均小于模型A(表3)，模型B与模型A在旋前、旋后工况下最大应力的差值百分比分别为10.33%，19.12%，而模型C与模型A在两种工况下最大应力差值百分比分别为8.01%，19.95%；模型B与模型A在旋前、旋后工况下最大位移值的差值百分比分别为1.67%，15.81%，而模型C与模型A在两种工况下最大位移值差值百分比分别为8.18%，9.14%。下尺桡关节位移云图显示模型B、C相比模型A位移峰值区域更小。应力云图显示，在旋前工况下应力峰值区域向掌侧偏移，在旋后工况下向背侧偏移，与实际情况相符，模型B、C相比模型A应力峰值区域向中心回移(图6，7)。 2.2 各工况下桡骨远端骨折端的相对位移与应力变化情况模型B和模型C远端骨折端在两种工况下的最大应力值与最大位移值均小于模型A(表3)，模型B与模型A在旋前、旋后工况下最大应力的差值百分比分别为12.02%，18.05%，而模型C与模型A在两种工况下最大应力差值百分比分别为18.43%，26.77%；模型B与模型A在旋前、旋后工况下最大位移值的差值百分比分别为17.48%，10.51%，而模型C与模型A在两种工况下最大位移值差值百分比分别为18.05%，17.76%。远端骨折端位移云图显示，模型B和C的位移峰值区域明显小于模型A。从应力分布来看，旋前工况下应力峰值区域向掌侧移动，旋后工况下则偏向背侧，这与临床观察一致。值得注意的是，相较于模型A，模型B和C的应力峰值区域更靠近中心区域(图8，9)。云图中应力峰值集中区域偏移了中心区域意味着相应结构出现不稳定使应力向外侧集中，下尺桡关节和远端骨折端在应力作用下容易出现向外侧的移位，影响结构稳定性。研究结果表明，无论是夹板外固定还是克氏针内固定，都能显著提升骨折端与下尺桡关节的稳定性，有效控制相对位移，保持应力分布的均衡性。根据差值百分比对照，两种固定方式的最大应力和位移值没有明显差别，说明它们在固定下尺桡关节与远端骨折端的效能不相上下。 "

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