ArticleAdvances in orthopedics2024
Finite Element Analysis of Protective Measures against Lateral Hinge Fractures in High-Tibial Osteotomy.
Article in Advances in orthopedics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Evaluation of the effectiveness of Kirschner wires in preventing lateral hinge fractures in high tibial osteotomy: A finite element analysis.Joint diseases and related surgery · 2025Article
- Is it beneficial to use lateral protective crossing K-wires during medial open wedge high tibial osteotomy? A retrospective comparative study.Journal of orthopaedic surgery and research · 2025Article
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Authors and funding
5 authors.
Funding
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Abstract
Background: Opening wedge high-tibial osteotomy (OWHTO) is widely used for correcting mechanical axis deviations and offloading the medial compartment in unicompartmental osteoarthritis. However, lateral hinge fractures (LHFs) pose a significant complication. This study investigates protective measures to mitigate these fractures, guided by prior observations of mechanical stress impact on LHFs. Purpose: The study aims to assess the effectiveness of different protective measures, specifically the use of varying sizes of Kirchner wires and drill holes, in reducing the incidence of LHFs during OWHTO. Methods: Using CT-based FEM, the study compares the impact of different sizes of K-wires (1.6 mm, 2.0 mm, and 2.5 mm) and drill holes (3.2 mm and 4.5 mm) on the mechanical stresses around the hinge area in OWHTO. The models were created from a CT scan of a healthy 33-year-old male, focusing on the force required to open the osteotomy gap and the incidence of cracked shell elements. Results: The study found that thicker K-wires increased the force required to open the osteotomy gap, whereas larger apical holes decreased it. The 4.5 mm apical hole model demonstrated significantly fewer cracks compared to the 2.0 mm K-wire model, with no significant difference observed compared to the 2.5 mm K-wire model. Models using a 1.6 mm K-wire or a 3.2 mm drill hole did not significantly reduce cracks compared to the base model. Conclusions: The findings suggest that a 4.5 mm drill hole may be more effective in reducing the risk of LHFs compared to thinner diameter K-wires or smaller apical holes. Both a 2.5 mm K-wire and a 4.5 mm drill hole reduce the number of cracked elements, but the 4.5 mm drill hole also significantly decreases the average and maximum principal stresses as well as the average tensile strength ratio at the hinge area. These findings may be important for surgical planning, particularly in cases requiring increased osteotomy distraction.
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Registered trials
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