Percutaneous fixation of intraarticular joint-depression calcaneal fractures with different screw configurations – a biomechanical human cadaveric analysis.

Purpose: The aim of this study was to assess the biomechanical performance of different screw configurations for fixation of Sanders type II B joint-depression calcaneal fractures. Methods: Fifteen human cadaveric lower limbs were amputated and Sanders II B fractures were simulated. The specimens we...

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Publicado en:European Journal of Trauma & Emergency Surgery Vol. 48; no. 4; pp. 3305 - 3316
Autores principales: Ivanov, Stoyan, Stefanov, Aleksandar, Zderic, Ivan, Rodemund, Christian, Schepers, Tim, Gehweiler, Dominic, Dauwe, Jan, Pastor, Torsten, Makelov, Biser, Raykov, Dimitur, Richards, Geoff, Gueorguiev, Boyko
Formato: diagnostic images pictorial research tables/charts Journal Article
Publicado: Springer Nature Aug2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2022
      vid: 48
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-022-01901-6
        158431700
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        atl: Percutaneous fixation of intraarticular joint-depression calcaneal fractures with different screw configurations – a biomechanical human cadaveric analysis.
      aug:
        au:
          Ivanov, Stoyan
          Stefanov, Aleksandar
          Zderic, Ivan
          Rodemund, Christian
          Schepers, Tim
          Gehweiler, Dominic
          Dauwe, Jan
          Pastor, Torsten
          Makelov, Biser
          Raykov, Dimitur
          Richards, Geoff
          Gueorguiev, Boyko
        affil: AO Research Institute Davos, Davos, Switzerland
      sug:
        subj:
          Calcaneus Fractures Surgery
          Fracture Fixation Methods
          Bone Screws
          Biomechanics
          Human
          Cadaver
          Female
          Male
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Random Assignment
          Descriptive Statistics
          Bone Density
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Female
          Male
      ab: Purpose: The aim of this study was to assess the biomechanical performance of different screw configurations for fixation of Sanders type II B joint-depression calcaneal fractures. Methods: Fifteen human cadaveric lower limbs were amputated and Sanders II B fractures were simulated. The specimens were randomized to three groups for fixation with different screw configurations. The calcanei in Group 1 were treated with two parallel longitudinal screws, entering superiorly the Achilles tendon insertion, and two screws fixing the intraarticular posterior facet fracture line. In Group 2 two screws entered the tuberosity inferiorly to the Achilles tendon insertion and two transverse screws fixed the posterior facet. In Group 3 two screws were inserted along the bone axis, one transverse screw fixed the posterior facet and one oblique screw was inserted from the posteroplantar part of the tuberosity supporting the posterolateral part of the posterior facet. All specimens were biomechanically tested to failure under progressively increasing cyclic loading. Results: Initial stiffness did not differ significantly between the groups, P = 0.152. Cycles to 2 mm plantar movement were significantly higher in both Group 1 (15,847 ± 5250) and Group 3 (13,323 ± 4363) compared with Group 2 (4875 ± 3480), P ≤ 0.048. No intraarticular displacement was observed in any group during testing. Conclusions: From a biomechanical perspective, posterior facet support by means of buttress or superiorly inserted longitudinal screws results in less plantar movement between the calcaneal tuberosity and the anterior fragments. Inferiorly inserted longitudinal screws are associated with bigger interfragmentary movements.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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