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

作     者：Tosan Okoro Kar Hao Teoh Hiro Tanaka 

作者机构：Department of ArthroplastyRobert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation TrustOswestry SY107AGUnited Kingdom Department of Orthopaedic SurgeryPrincess Alexandra Hospital NHS TrustHarlow CM201QXUnited Kingdom Department of OrthopaedicsRoyal Gwent HospitalNewport NP202UBUnited Kingdom 

出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)

年 卷 期：2021年第12卷第8期

页      面：548-554页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：Supported by Research Grant Provided by AOUK 

主　　题：Unstable ankle fractures Pro-tibia fixation Improved stability Simulated biomechanical analysis Osteoporotic fractures Ankle injuries 

摘      要：BACKGROUND Locking plate fixation in osteoporotic ankle fractures may fail due to cut-out or metalwork *** 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 *** locking plates,the strength of this fixation construct can be further *** is lack of evidence currently on the merits of tibiapro-fibula augmented locking plate fixation of unstable ankle *** 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 *** Ten osteoporotic saw bones with simulated supination external rotation injuries were *** saw bones were fixed with standard locking plates whilst the other 5 saw bones were fixed with locking plates in a fibula pro-tibia *** fibula pro-tibia construct involved fixation with 3 consecutive locking screws applied across 3 cortices proximally from the level of the *** 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 *** 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 *** 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 ***