| Autor: |
Klos K; Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany.; Foot and Ankle Division, Gelenkzentrum Rhein-Main, Frankfurter Str. 94, 65239 Hochheim am Main, Germany., Simons P; Foot and Ankle Division, St. Josefs-Hospital Rheingau, Eibinger Str. 9, 65385 Rüdesheim am Rhein, Germany., Schopp P; Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany., Schenk P; Research Executive Department, BG Klinikum Bergmannstrost, 06112 Halle, Germany., Kohler FC; Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany., Uddin A; Department of Podiatric Surgery, Northamptonshire Healthcare NHS Foundation Trust, Danetre Hospital, London Road, Northamptonshire NN11 4DY, UK.; Department of Podiatric Surgery, Essex Partnership University NHS Foundation Trust, Rochford Hospital, Essex, Rochford SS4 1RB, UK., Roth EK; Foot and Ankle Division, Gelenkzentrum Rhein-Main, Frankfurter Str. 94, 65239 Hochheim am Main, Germany., Biedermann U; Institute of Anatomy I, Jena University Hospital, Friedrich Schiller University Jena, 07743 Jena, Germany., Hofmann GO; Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany., Lenz M; Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany. |
| Abstrakt: |
Plantar plate positioning has been demonstrated as biomechanically superior. However, some operators remain resentful about the morbidity of the surgical approach. To provide improved plate fixation for first tarsometatarsal joint arthrodesis with respect to the tibialis anterior tendon, a medio-plantar plate was developed. The purpose of this biomechanical study was to compare its construct stability to that of a plantar plate construct. Twelve pairs of fresh frozen human specimens were used in a matched pair test. Each pair was fixed with a 4 mm compression screw and either a plantar locking plate or a medio-plantar locking plate. A cantilever beam test was performed in dorsiflexion. Before and after cyclic loading (5000 cycles; 40 N), bending stiffness and relative movements at the joint space were monitored in a quasi-static test including optical motion tracking. Maximum load and bending moment to failure were investigated in a load-to-failure ramp test. The bending stiffness of both groups did not significantly differ before (plantar 49.9 N/mm ± 19.2; medio-plantar 53.9 N/mm ± 25.4, p = 0.43) or after (plantar 24.4 N/mm ± 9.7; medio-plantar 35.3 N/mm ± 22.0, p = 0.08) cyclic loading but decreased significantly in both groups ( p < 0.01) after cyclic loading. Relative movement increased significantly during cyclic testing in both groups ( p < 0.01) but did not differ significantly between the groups before ( p = 0.29) or after ( p = 0.16) cyclic loading. Neither load nor bending moment to failure were significantly different (plantar 225 N ± 78, 10.8 Nm; medio-plantar 210 N ± 86, 10.1 Nm, p = 0.61). Both plate constructs provided equivalent construct stability, both being well suited for Lapidus arthrodesis. |
