The role of fibular fixation in combined fractures of the tibia and fibula: a biomechanical investigation

Journal of Orthopaedic Trauma
T G WeberA F Tencer

Abstract

To determine whether adjunctive plating of the fibula with tibial fixation enhanced the stability of the construct under combined compressive and bending loads in simulated fractures of both the tibia and fibula. Each of twelve fresh cadaveric specimens (six pairs) with an intact knee, lower extremity, and foot was mounted on the table of a materials testing machine. An intramedullary (IM) rod locked in the distal femur allowed combined compression, and flexion, valgus bending, or varus bending loads to be transmitted from the actuator of the testing machine to the knee. Three displacement measurement transducers were mounted on the tibia at anterior, posterolateral, and posteromedial positions. Intact tibial deformations under load were measured. Then, in one specimen of each pair a 2 cm osteotomy was created near the tibial midshaft, which was stabilized with an external fixator. Tibial gap displacements were measured under the following conditions: (a) intact fibula, (b) osteotomized fibula, (c) fibula fixed with a plate, (d) fibula fixed with an Enders IM nail. In the other specimen of the pair, tibial fixation was performed with an interlocked unreamed IM nail, with the same successive stages of fibular fixation. Osteotomy...Continue Reading

References

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Citations

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