Stabilization of the syndesmosis in the Maisonneuve fracture--a biomechanical study comparing 2-hole locking plate and quadricortical screw fixation

Journal of Orthopaedic Trauma
Richard GardnerMark Jackson

Abstract

The aim of this study is to determine whether a 2-hole locking plate has biomechanical advantages over conventional screw stabilization of the syndesmosis in this injury pattern. Six pairs of fresh-frozen human cadaver lower legs were prepared to simulate an unstable Maisonneuve fracture. Each limb was compared with its pair; the syndesmosis in one being stabilized with two 4.5-mm quadricortical cortical screws, the other a 2-hole locking plate with 3.2-mm locking screws. The limbs were then mounted on a servohydraulic testing rig and axially loaded to a peak load of 800N for 12000 cycles. Fibula shortening and diastasis were measured. Each limb was then externally rotated until failure occurred. Failure was defined as fracture of bone or metalwork, syndesmotic widening, or axial migration >2 mm. Both constructs effectively stabilized the syndesmosis during the cyclical loading within 0.1 mm of movement. However, the locking plate group demonstrated greater resistance to torque compared with quadricortical screw fixation (40.6 Nm vs. 21.2 Nm, respectively, P value < 0.03). A 2-hole locking plate (with 3.2-mm screws) provides significantly greater stability of the syndesmosis to torque when compared with 4.5-mm quadricortical fi...Continue Reading

References

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Citations

Aug 21, 2013·Current Reviews in Musculoskeletal Medicine·Kenneth J Hunt
Jun 4, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·S Rammelt, P Obruba
Sep 28, 2015·Clinics in Sports Medicine·Paul J SwitajAnish R Kadakia
Jun 5, 2016·Foot and Ankle Clinics·Cristián A OrtizEmilio Wagner
Sep 11, 2016·Foot & Ankle Specialist·Douglas E LucasChristopher F Hyer
Feb 5, 2014·Foot & Ankle International·James R Jastifer
Jan 20, 2017·Current Reviews in Musculoskeletal Medicine·Matthew L VopatChristopher W DiGiovanni
Jul 17, 2018·Computer Methods in Biomechanics and Biomedical Engineering·Haobo LiXiaoyang Jia
Jan 19, 2019·Foot & Ankle International·Jorge BricenoJohn Y Kwon
Dec 18, 2020·Orthopaedics & Traumatology, Surgery & Research : OTSR·Olivier CornuDan Putineanu
Apr 4, 2014·The Journal of Bone and Joint Surgery. American Volume·Tyler J Van Heest, Paul M Lafferty
Aug 26, 2021·Annals of Medicine and Surgery·Hassan ShafiqBasharat Ghafoor Khan

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