Biomechanical Effects of Four Different Configurations In Salter Harris Type 4 Distal Femoral Epiphyseal Fractures

In this study, the biomechanicaleffects of four different configurations (Parallel K wires, Parallel Screw, Upper K wire-Lower Screw, Upper Screw-Lower K wire), which are used for stabilizing Salter-Harris (SH) Type 4 epiphyseal fracture of distal femur after reduction process, on the epiphyseal plate has been investigated under axial, rotational and bendingforces in order to determine the most advantageous configuration. The fourdifferent configurations have been modeled by using SolidWorks and computer-aided numerical analyses were performed by finite element analysis software. The mesh process, boundary conditions and material model have been applied in finite element analysis software for each configuration. In addition, von-Mises stress values on epiphyseal plate, screws and K wires have been calculated. There is a general near trend on stress values in all configurations on physis line under bending (varus-valgus angulation, anterior-posterior angulation) and torsional forces in the frontal, sagittal and transverse plane respectively. Considering the axial forces, the highest stress was found on parallel K- wires configuration in physis while the lowest stress was found in parallel screw configuration. It has been found particularly advantageous to use fixation type in parallel screw configuration. In addition, in SH type 4 epiphyseal fracture, fixation type is found to be disadvantageous in K wire configuration