Fibula pro-tibia vs standard locking plate fixation in an ankle fracture saw bone model  

作　　者：Tosan Okoro Kar Hao Teoh Hiro Tanaka 

机构地区：[1]Department of Arthroplasty,Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust,Oswestry SY107AG,United Kingdom [2]Department of Orthopaedic Surgery,Princess Alexandra Hospital NHS Trust,Harlow CM201QX,United Kingdom [3]Department of Orthopaedics,Royal Gwent Hospital,Newport NP202UB,United Kingdom

出　　处：《World Journal of Orthopedics》2021年第8期548-554,共7页世界骨科杂志（英文版）

基　　金：Supported by Research Grant Provided by AOUK.

摘　　要：BACKGROUND Locking plate fixation in osteoporotic ankle fractures may fail due to cut-out or metalwork failure.Fibula pro-tibia fixation was a technique prior to the advent of locking plates that was used to enhance stability in ankle fractures by achieving tri or tetra-cortical fixation.With locking plates,the strength of this fixation construct can be further enhanced.There is lack of evidence currently on the merits of tibiapro-fibula augmented locking plate fixation of unstable ankle fractures.AIM To assess if there is increased strength to failure,in an ankle fracture saw bone model,with a fibula pro-tibia construct when compared with standard locking plate fixation.METHODS Ten osteoporotic saw bones with simulated supination external rotation injuries were used.Five saw bones were fixed with standard locking plates whilst the other 5 saw bones were fixed with locking plates in a fibula pro-tibia construct.The fibula pro-tibia construct involved fixation with 3 consecutive locking screws applied across 3 cortices proximally from the level of the syndesmosis.All fixations were tested in axial external rotation to failure on an electromagnetic test frame(MTS 858 Mini-Bionix test machine,MTS Corp,Eden Praire,MN,United States).Torque at 30 degrees external rotation,failure torque,and external rotation angle at failure were compared between both groups and statistically analyzed.RESULTS The fibula pro-tibia construct demonstrated a statistically higher torque at 30 degrees external rotation(4.421±0.796 N/m vs 1.451±0.467 N/m;t-test P=0.000),as well as maximum torque at failure(5.079±0.694N/m vs 2.299±0.931 N/m;t-test P=0.001)compared to the standard locking plate construct.The fibula pro-tibia construct also had a lower external rotation angle at failure(54.7±14.5 vs 67.7±22.9).CONCLUSION The fibula pro-tibia locking plate construct demonstrates biomechanical superiority to standard locking plates in fixation of unstable ankle fractures in this saw bone model.There is merit in the use of this construct in p

关 键 词：Unstable ankle fractures Pro-tibia fixation Improved stability Simulated biomechanical analysis Osteoporotic fractures Ankle injuries 

分 类 号：R687.3[医药卫生—骨科学]