Novel Spiked-Washer Repair Is Biomechanically Superior to Suture and Bone Tunnels for Arcuate Fracture Repair
| Autor: | Yi-Xian Qin, David E. Komatsu, Jian Jiao, Saman Vojdani, Steven Ortiz, Tyler Enders, James Penna, Liangjun Lin, Laviel Fernandez, Charles J. Ruotolo |
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| Rok vydání: | 2017 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_specialty Washer Compressive Strength genetic structures medicine.medical_treatment Bone Screws Knee Injuries Bone healing Osteotomy Article 030218 nuclear medicine & medical imaging Weight-Bearing Fracture Fixation Internal 03 medical and health sciences 0302 clinical medicine Cadaver Fracture fixation medicine Humans Orthopedics and Sports Medicine Fibula Aged Fracture Healing Fibrous joint 030222 orthopedics business.industry Avulsion fracture General Medicine musculoskeletal system medicine.disease Surgery Fractures Avulsion Treatment Outcome medicine.anatomical_structure Stress Mechanical business |
| Zdroj: | Journal of Orthopaedic Trauma. 31:e81-e85 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000000752 |
| Popis: | Injuries to the posterolateral corner of the knee can lead to chronic degenerative changes, external rotation instability, and varus instability if not repaired adequately. A proximal fibula avulsion fracture, referred to as an arcuate fracture, has been described in the literature, but a definitive repair technique has yet to be described. The objective of this study was to present a novel arcuate fracture repair technique, using a spiked-washer with an intramedullary screw, and to compare its biomechanical integrity to a previously described suture and bone tunnel method.Ten fresh-frozen cadaveric knees underwent a proximal fibula osteotomy to simulate a proximal fibula avulsion fracture. The lateral knee capsule and posterior cruciate ligament were also sectioned to create maximal varus instability. Five fibulas were repaired using a novel spiked-washer technique and the other 5 were repaired using the suture and bone tunnel method. The repaired knees were subjected to a monotonic varus load using a mechanical testing system instrument until failure of the repair or associated posterolateral corner structures.Compared with the suture repair group, the spiked-washer repair group demonstrated a 100% increase in stiffness, 100% increase in yield, 110% increase in failure force, and 108% increase in energy to failure.The spiked-washer technique offers superior quasi-static biomechanical performance compared with suture repair with bone tunnels for arcuate fractures of the proximal fibula. Further clinical investigation of this technique is warranted and the results of this testing may lead to improved outcomes and patient satisfaction for proximal fibula avulsion fractures. |
| Databáze: | OpenAIRE |
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