ArticleJoint diseases and related surgery2025
Evaluation of the effectiveness of Kirschner wires in preventing lateral hinge fractures in high tibial osteotomy: A finite element analysis.
Article in Joint diseases and related surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Reinforcement K-wires reduce the risk of tibial plateau and lateral cortex fractures during open wedge high tibial osteotomy: a prospective comparative cohort study.BMC musculoskeletal disorders · 2026Article
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6 authors.
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Abstract
objectivesThis study aims to investigate the effect of Kirschner wires (K-wires) placed in the lateral hinge on lateral cortical fractures occurring during medial opening wedge high tibial osteotomy (MOWHTO) technique. PATIENTS AND
methodsThe mechanics of different models were compared using the finite element analysis and mathematical simulations. The first model is without K-wire control model, the second and third models are with one and two K-wires, respectively. The gap displacement (mm), gap distance (mm), correction angle (°), cortical-cancellous bone stresses (MPa), and stiffness (N/mm) of the hinge were used as outputs to compare the models. The effect of the position of the K-wire in the lateral hinge on the hinge stress and opening angle was also examined.
resultsThe K-wires applied to the lateral hinge to prevent lateral cortex fracture reduced the hinge stress and increased the hinge stiffness. Higher force values were required to open the same amount of osteotomy compared to osteotomies without K-wires, which was a direct effect of increased hinge stiffness. Getting closer to the hinge for the K-wire position decreased the maximum stress value at the hinge and caused lower opening angles.
conclusionThe higher force requirement for opening the osteotomy with K-wire application may reduce the risk of lateral hinge fracture by providing a more controlled and safer osteotomy opening, particularly for less experienced surgeons. Additionally, getting closer to the hinge for the K-wire position plays a positive role in preventing lateral hinge fractures. However, the opening angle decreases as the K-wire gets closer to the hinge.
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