Primary stability and stiffness in ankle arthrodes-Crossed screws versus anterior plating
Primary stability and stiffness in ankle arthrodes-Crossed screws versus anterior plating
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DOI：
10.1016/j.fas.2013.04.006
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发表时间：
2013-09-01
影响因子：
2.5
通讯作者：
Espinosa, Norman
中科院分区：
文献类型：
--
作者：
Betz, Michael M.;Benninger, Emanuel E.;Espinosa, Norman
背景：踝关节融合术通常用于治疗骨关节炎或关节置换术失败。螺钉固定是踝关节融合术的主要技术。由于失败的频率相当高，研究表明使用解剖学形状的前路双钢板系统作为孤立胫距关节融合术的可靠方法。本生物力学研究的目的是比较两组踝关节融合结构-三螺钉固定和前双板系统-在初级稳定性和stiffen.Methods：6匹配对人类尸体小腿（Thiel固定）在这项研究中使用。每对中的一个样本被随机分配使用前路双钢板系统进行稳定，另一个使用三螺钉技术进行稳定。通过背屈足部直至系统失效（定义为矢状面中距骨相对于胫骨的旋转）来测试不同的关节固定方法。实验在万能材料试验机上进行。记录关节融合失败所需的力。对于刚度的计算，一个线性回归拟合的力-位移曲线的线性部分的曲线和其斜率作为stiffic.Results：对于解剖形状的双板系统的平均载荷为967 N（范围从570 N到1400 N），使关节融合失败。三螺钉固定方法可承受190 N（范围100 N-280 N）的平均载荷（p = 0.005）。刚度平均值为56 N/mm解剖形状的双钢板系统达到了（范围从35 N/mm到79 N/mm），而平均为10 N/mm对于三螺钉固定方法，达到了6 N/mm至18 N/mm的范围（p = 0.004）.结论：我们的生物力学数据表明，前路双钢板系统明显上级三钢板系统，螺钉固定技术在踝关节融合术中的初期稳定性和刚度。(C)2013年欧洲足踝协会。由爱思唯尔有限公司出版。保留所有权利。
Background: Ankle arthrodesis is commonly used for the treatment of osteoarthritis or failed arthroplasty. Screw fixation is the predominant technique to perform ankle arthrodesis. Due to a considerable frequency of failures research suggests the use of an anatomically shaped anterior double plate system as a reliable method for isolated tibiotalar arthrodesis. The purpose of the present biomechanical study was to compare two groups of ankle fusion constructs - three screw fixation and an anterior double plate system - in terms of primary stability and stiffness.Methods: Six matched-pairs human cadaveric lower legs (Thiel fixated) were used in this study. One specimen from each pair was randomly assigned to be stabilized with the anterior double plate system and the other with the three-screw technique. The different arthrodesis methods were tested by dorsiflexing the foot until failure of the system, defined as rotation of the talus relative to the tibia in the sagittal plane. Experiments were performed on a universal materials testing machine. The force required tomake arthrodesis fail was documented. For calculation of the stiffness, a linear regression was fitted to the force-displacement curve in the linear portion of the curve and its slope taken as the stiffness.Results: For the anatomically shaped double-plate system a mean load of 967 N was needed (range from 570 N to 1400 N) to make arthrodesis fail. The three-screw fixation method resisted a mean load of 190 N (range from 100 N to 280 N) (p = 0.005). In terms of stiffness a mean of 56 N/mm (range from 35 N/mm to 79 N/mm) was achieved for the anatomically shaped double-plate system whereas a mean of 10 N/mm (range from 6 N/mm to 18 N/mm) was achieved for the three-screw fixation method (p = 0.004).Conclusions: Our biomechanical data demonstrates that the anterior double-plate system is significantly superior to the three-screw fixation technique for ankle arthrodesis in terms of primary stability and stiffness. (C) 2013 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.