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Comprehensive biomechanical analysis of three clinically used fixation constructs for posterior malleolar fractures using cadaveric and finite element analysis(Open Access)

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机构: [1]Institute of Translational Medicine, China Medical University, No.77 Puhe Road, North New Area,Shenyang 110122, Liaoning, People’s Republic of China [2]Department of Orthopaedic Surgery, The Second Hospitalof Chaoyang City, No 26, Secttion 4 Chaoyang street, Chaoyang, Liaoning, People’s Republic of China [3]Departmentof Human Anatomy, School of Basic Medical Science, China Medical University, No.77 Puhe Road, 110122 NorthNew Area, Shenyang, Liaoning, People’s Republic of China [4]Department of Orthopaedic Surgery, The SecondAffiliated Hospital of Dalian Medical University, 456 Zhong Shan Road, Dalian 116027, Liaoning, People’s Republicof China [5]Engineering Research Center of Continuous Extrusion, Ministry of Education, Dalian Jiaotong University,794 Yellow River Road, Dalian 116028, Liaoning, People’s Republic of China [6]Department of Anesthesia, TheSecond Affiliated Hospital of Dalian Medical University, 456 Zhong Shan Road, Dalian 116027, Liaoning, People’sRepublic of China [7]Department of Railway Vehicle, Ji Lin Railway Technology College, 1 Ji Hua East road, 132200 JiLin, People’s Republic of China [8]Department of Orthopaedic Surgery, The First Affiliated Hospital of ChinaMedical University, 155 Nanjing street, Shenyang 110001, Liaoning, People’s Republic of China [9]Departmentof Orthopaedic Surgery, The First Affiliated Hospital of Dalian Medical University, 222 Zhong shan road, Dalian,Liaoning 116011, People’s Republic of China [10]Department of Orthopaedic Surgery, The 920Th Hospital of JointLogistics Support Force, Kunming 650032, Yunnan, People’s Republic of Chin
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Different fixation modalities are available for fixation of posterior malleolar fractures (PMFs), but the best method is still unclear. The purpose of this study was to carry out a comparative biomechanical analysis of three commonly used fixation constructs for PMFs using experimental and finite element analysis (FEA). 15 human cadaveric ankle specimens were randomly divided into three groups. Specimens in group-A were fixed with two anteroposterior (AP) lag screws, group-B with two posteroanterior (PA) lag screws, and for group-C, a posterior plate was used. Each model was subjected to axial load. Outcomes included loads for 0.5 mm, 1 mm, 1.5 mm, and 2 mm vertical displacements of posterior fragments were noted. 3D FE models were reconstructed from computed tomography (CT) images and subjected to vertical loads. The model’s stress, fracture step-off, and resultant strains in implants were also studied in 3D FE models. Significantly higher amounts of mean compressive loads were observed to cause the same amount of vertical displacements in plate group (265 ± 60.21 N, 796 ± 57.27 N, 901.18 ± 8.88 N, 977.26 ± 13.04 N) than AP (102.7 ± 16.78 N, 169.5 ± 19.91 N, 225.32 ± 15.92 N, 269.32 ± 17.29 N) and PA (199.88 ± 31.43 N, 362.80 ± 28.46 N, 431.3 ± 28.12 N, 541.86 ± 36.05 N) lag screws respectively (P < 0.05). Simulated micro-motion analysis demonstrated that fracture step-off values in plate group (0.03 ± 0.001 mm, 0.06 ± 0.003 mm and 0.13 ± 0.010 mm) were the lowest among the three groups (P < 0.001). The cancellous bone showed the highest amount of stress in AP and PA lag groups respectively, whereas the lowest stress was noted in the plate-group. This biomechanical study concluded that posterior plating is biomechanically the most stable fixation construct for PMFs fixation. AP and PA lag screws with higher bone stress and fracture step-off values have a high tendency of bone cut-through and loss of fixation respectively. © 2020, The Author(s).

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出版当年[2020]版:
大类 | 3 区 综合性期刊
小类 | 3 区 综合性期刊
最新[2023]版:
大类 | 2 区 综合性期刊
小类 | 2 区 综合性期刊
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Q1 MULTIDISCIPLINARY SCIENCES
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Q1 MULTIDISCIPLINARY SCIENCES

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第一作者机构: [1]Institute of Translational Medicine, China Medical University, No.77 Puhe Road, North New Area,Shenyang 110122, Liaoning, People’s Republic of China
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