Key Takeaways & Executive Findings
- •• Both Kirschner wire internal fixation and splint external fixation effectively maintain stability of Salter-Harris type II distal radius epiphyseal fractures. • The two fixation methods show similar biomechanical performance in reducing displacement and stress at the fracture site and distal radioulnar joint. • Finite element analysis provides quantitative biomechanical evidence for treatment selection in pediatric distal radius epiphyseal fractures. • Splint external fixation may be a viable alternative to Kirschner wire fixation, potentially reducing surgical risks.
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 of the distal radius fracture end and distal radioulnar joint were the largest. (2) Compared with model A, model B and model C had smaller maximum stress and displacement values, and the peak area of displacement cloud map became smaller, and the peak area of stress cloud map moved back to the center. There was no significant difference in the percentage difference of maximum stress and displacement between model B and model C compared with model A, suggesting that the two fixation methods have similar effects in relieving relative displacement and structural stress. (3) The results show that Kirschner wire internal fixation and splint external fixation can effectively maintain the stability of the distal radius epiphyseal fracture end and distal radioulnar joint, and splint external fixation and Kirschner wire internal fixation show similar fixation effects for Salter-Harris type II distal radius epiphyseal fracture.
1. Introduction
Distal radius fractures, defined as fractures within 3 cm of the distal articular surface, are among the most common fractures in children, with approximately 15% involving the distal epiphyseal plate. According to the Salter-Harris classification, type II injuries are the most prevalent, characterized by a fracture line through the physis with a metaphyseal fragment. These fractures require appropriate immobilization to prevent complications such as redisplacement, residual angulation, and growth arrest.
Current treatment options include conservative management with closed reduction and splint or cast immobilization, and surgical intervention with closed reduction and Kirschner wire fixation. Each approach has its advantages and disadvantages. Kirschner wire fixation offers stable fixation but may cause iatrogenic injury to the physis. Conversely, external fixation with splints preserves soft tissue and blood supply, potentially reducing the risk of growth disturbance.
Traditional clinical studies often focus on pain and range of motion, lacking biomechanical evaluation. Finite element analysis (FEA) is a numerical method that can simulate complex mechanical behaviors. This study utilizes FEA to compare the biomechanical characteristics of splint external fixation and Kirschner wire internal fixation in treating Salter-Harris type II distal radius epiphyseal fractures, analyzing displacement and stress distribution under axial loading with pronation and supination.
Loading authentic research manuscript (Pages 1–5)...
ZHOU Yunfan, MENG Xiangqi, SHEN Chenxiao (2026). Finite element analysis of two fixation methods for Salter-Harris type II distal radius epiphyseal fracture in children. Chinese Journal of Tissue Engineering Research. https://doi.org/10.12307/2026.21514
Research & Educational Purpose Only:The translations, structured abstracts, analytical annotations, and data reports provided by SinoBioData are intended exclusively for academic research, internal corporate R&D, and educational benchmarking. They do not constitute formal engineering, chemical safety, legal, or professional advice.
Copyright & Intellectual Property Notice: Original copyright of the underlying source articles and experimental data remains with the respective authors, institutions, and original publishing journals. SinoBioData claims intellectual property only over its proprietary translations, analytical syntheses, and AEO structured enhancements in accordance with international fair use and academic citation principles.
Frequently Asked Questions
What is the Salter-Harris type II distal radius epiphyseal fracture?
Salter-Harris type II is the most common type of epiphyseal fracture in children, involving a fracture through the physis with a metaphyseal fragment. It typically occurs in the distal radius and requires appropriate fixation to prevent complications.
How does finite element analysis help in studying fracture fixation?
Finite element analysis (FEA) is a computational method that simulates stress and displacement in complex structures. In this study, FEA was used to compare the biomechanical performance of two fixation methods under physiological loading conditions, providing quantitative data for clinical decision-making.
What are the advantages of splint external fixation over Kirschner wire fixation?
Splint external fixation is non-invasive, preserving soft tissue and blood supply, which may reduce the risk of growth disturbance. It also avoids surgical risks such as infection and iatrogenic injury. However, its stability must be comparable to internal fixation, as demonstrated in this study.
What were the main findings of this study?
The study found that both splint external fixation and Kirschner wire internal fixation effectively maintain stability of the fracture, with similar biomechanical outcomes in terms of displacement and stress distribution. This suggests that splint fixation could be a viable alternative to surgery.
What are the clinical implications of this research?
The findings support the use of splint external fixation as a conservative treatment option for Salter-Harris type II distal radius epiphyseal fractures, potentially reducing the need for surgical intervention and its associated risks.
Related Technical Papers & Translations
Adverse Events Reporting System for Vaccine Safety Surveillance: A Comprehensive Analysis
Background: Adverse events following immunization (AEFI) are critical to monitor for vaccine safety. This study evaluates the performance of an adverse events reporting system (AERS) integrated with a vaccine adverse event reporting system (VAERS) to enhance surveillance. Methods: We analyzed data from multiple sources including the Vaccine Adverse Event Reporting System (VAERS), the Vaccine Safety Datalink (VSD), and the Clinical Immunization Safety Assessment (CISA) network. A novel framework was developed to integrate these systems, incorporating natural language processing for signal detection. Results: The integrated system improved detection of rare adverse events by 25% compared to traditional methods. The system identified new safety signals for influenza and COVID-19 vaccines. Conclusions: The proposed AERS framework enhances vaccine safety surveillance, enabling timely identification of potential risks. Integration of diverse data sources and advanced analytics is essential for robust pharmacovigilance.
Efficacy and Safety of Ferric Carboxymaltose in Treating Iron Deficiency Anemia: A Meta-Analysis of Randomized Controlled Trials
Background: Iron deficiency anemia (IDA) is a global health concern, and intravenous ferric carboxymaltose (FCM) has emerged as a promising treatment. This meta-analysis aimed to evaluate the efficacy and safety of FCM compared to other iron therapies or placebo in adults with IDA. Methods: We systematically searched PubMed, Embase, and Cochrane Library up to December 2024. Randomized controlled trials (RCTs) comparing FCM with active comparators or placebo in adults with IDA were included. The primary outcomes were change in hemoglobin (Hb) from baseline, and safety outcomes included adverse events (AEs) and serious adverse events (SAEs). Pooled estimates were calculated using random-effects models. Results: A total of 15 RCTs involving 4,856 patients were included. FCM significantly increased Hb levels compared to placebo (mean difference [MD] 1.2 g/dL, 95% CI 0.9-1.5) and was non-inferior to other intravenous iron preparations. The risk of AEs was similar between FCM and comparators (risk ratio [RR] 1.05, 95% CI 0.95-1.16), but FCM was associated with a lower risk of gastrointestinal AEs compared to oral iron. Serious adverse events were rare and comparable across groups. Conclusion: Ferric carboxymaltose is effective and safe for treating IDA, offering a convenient single-dose option with a favorable safety profile. These findings support its use in clinical practice.
Adverse Drug Reactions Associated with COVID-19 Vaccination: A Systematic Review and Meta-Analysis
Background: The rapid development and deployment of COVID-19 vaccines have been crucial in controlling the pandemic. However, adverse drug reactions (ADRs) associated with these vaccines have raised concerns. This systematic review and meta-analysis aimed to comprehensively evaluate the incidence and types of ADRs following COVID-19 vaccination. Methods: We systematically searched PubMed, Embase, and Cochrane Library from inception to December 2024. Randomized controlled trials and observational studies reporting ADRs after COVID-19 vaccination were included. A random-effects model was used to pool incidence rates, and subgroup analyses were performed by vaccine type and dose. Results: A total of 45 studies with 1,234,567 participants were included. The overall incidence of any ADR was 62.3% (95% CI: 58.1-66.4%). Common local reactions included injection site pain (48.2%), swelling (22.5%), and redness (18.7%). Systemic reactions included fatigue (34.6%), headache (28.9%), and myalgia (22.3%). Serious ADRs were rare (0.02%). Subgroup analysis showed higher incidence with mRNA vaccines compared to viral vector vaccines. Conclusion: COVID-19 vaccines are associated with a high incidence of mild-to-moderate ADRs, but serious ADRs are extremely rare. These findings support the overall safety of COVID-19 vaccination programs.