Pediatric T-Condylar Humerus Fractures: A Systematic Review.

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Abstract

[Indexed for MEDLINE] 17. J Orthop Surg Res. 2025 Nov 19;20(1):1017. doi: 10.1186/s13018-025-06437-0. Kirschner wire configuration and fixation stability in pediatric supracondylar humerus fractures: a finite element analysis. Akar B(1), Iyibilgin O(2)(3), Oztürkmen Y(4), Soydas S(5), Yücel MO(6). Author information: (1)Department of Orthopedics and Traumatology, Sakarya Yenikent State Hospital, Sakarya, Turkey. (2)Mechanical Engineering Department, Sakarya University, Sakarya, Turkey. ibilgin@sakarya.edu.tr. (3)Biomaterials, Energy, Photocatalysis, Enzyme Technology, Nano and Advanced Materials, Additive Manufacturing, Environmental Applications and Sustainability Research and Development Group, Sakarya University, Sakarya, Turkey. ibilgin@sakarya.edu.tr. (4)Department of Orthopedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, Turkey. (5)Mechanical Engineering Department, Kocaeli University, Kocaeli, Turkey. (6)Faculty of Medicine, Department of Orthopedics and Traumatology, Düzce University, Düzce, Turkey. BACKGROUND: Pediatric supracondylar humerus fractures are among the most common elbow injuries in children and require stable fixation to prevent complications. Kirschner (K) wire osteosynthesis is a widely used technique; however, the optimal wire configuration remains a subject of debate. OBJECTIVE: This study aims to investigate the effects of three different K-wire configurations (crossed, medial-parallel, and lateral-parallel) on the fixation stability of pediatric supracondylar humerus fractures using finite element analysis (FEA). METHODS: A three-dimensional finite element model of a pediatric humerus with a supracondylar fracture was constructed. Each of the three K-wire configurations was virtually applied to the model. To replicate physiological conditions, force (Z-axis) and moment (X- and Y-axes) components were applied under various loading scenarios, both individually and in combination. Mechanical parameters, including displacement, stress distribution, and rigidity, were analyzed for each configuration. RESULTS: The crossed K-wire configuration demonstrated superior structural stability compared to both medial-parallel and lateral-parallel configurations. It exhibited lower displacement values and more favorable stress distribution, particularly under rotational loading conditions, indicating higher mechanical resistance. CONCLUSION: The findings suggest that the crossed K-wire configuration provides enhanced fixation stability and may be the most effective technique for the surgical treatment of pediatric supracondylar humerus fractures. Additionally, this study confirms the utility of finite element analysis as a robust and reliable method for evaluating the biomechanical performance of orthopedic fixation methods. © 2025. The Author(s). DOI: 10.1186/s13018-025-06437-0 PMCID: PMC12628628