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Biomechanical evaluation of different medial column fixation patterns for valgus pilon fractures.
- Source :
-
BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2024 Jul 11; Vol. 25 (1), pp. 533. Date of Electronic Publication: 2024 Jul 11. - Publication Year :
- 2024
-
Abstract
- Background: The purpose of this study was to perform a biomechanical analysis to compare different medial column fixation patterns for valgus pilon fractures in a case-based model.<br />Methods: Based on the fracture mapping, 48 valgus pilon fracture models were produced and assigned into four groups with different medial column fixation patterns: no fixation (NF), K-wires (KW), intramedullary screws (IS), and locking compression plate (LCP). Each group contained wedge-in and wedge-out subgroups. After fixing each specimen on the machine, gradually increased axial compressive loads were applied with a load speed of one millimeter per minute. The maximum peak force was set at 1500 N. Load-displacement curves were generated and the axial stiffness was calculated. Five different loads of 200 N, 400 N, 600 N, 800 N, 1000 N were selected for analysis. The specimen failure was defined as resultant loading displacement over 3 mm.<br />Results: For the wedge-out models, Group-IS showed less displacement (p < 0.001), higher axial stiffness (p < 0.01), and higher load to failure (p < 0.001) than Group-NF. Group-KW showed comparable displacement under loads of 200 N, 400 N and 600 N with both Group-IS and Group-LCP. For the wedge-in models, no statistical differences in displacement, axial stiffness, or load to failure were observed among the four groups. Overall, wedge-out models exhibited less axial stiffness than wedge-in models (all p < 0.01).<br />Conclusions: Functional reduction with stable fixation of the medial column is essential for the biomechanical stability of valgus pilon fractures and medial column fixation provides the enough biomechanical stability for this kind of fracture in the combination of anterolateral fixation. In detail, the K-wires can provide a provisional stability at an early stage. Intramedullary screws are strong enough to provide the medial column stability as a definitive fixation. In future, this technique can be recommended for medial column fixation as a complement for holistic stability in high-energy valgus pilon fractures.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Biomechanical Phenomena
Bone Screws
Fracture Fixation, Internal methods
Fracture Fixation, Internal instrumentation
Ankle Fractures surgery
Ankle Fractures diagnostic imaging
Ankle Fractures physiopathology
Bone Wires
Male
Weight-Bearing
Female
Adult
Middle Aged
Tibial Fractures surgery
Tibial Fractures diagnostic imaging
Tibial Fractures physiopathology
Bone Plates
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2474
- Volume :
- 25
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- BMC musculoskeletal disorders
- Publication Type :
- Academic Journal
- Accession number :
- 38992608
- Full Text :
- https://doi.org/10.1186/s12891-024-07660-2