Biomechanical comparison of three kinds of fixation instruments for calcaneal osteotomy_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

BAI Jiyue ¹ ,  XU Yongqing ² , HE Xiaoqing ² , LI Chuan ² , LIU Shuai ³ , LI Liang ³

1. Graduate Management Brigade, Army Medical University, Chongqing, 400038, P.R.China;
2. Department of Orthopedics, Kunming General Hospital, Chengdu Military Region of Chinese PLA, Kunming Yunnan, 650032, P.R.China;
3. Graduate Department of Kunming Medical University, Kunming Yunnan, 650032, P.R.China;

Corresponding author：

XU Yongqing, Email: xuyongqingkm@163.net

Keywords：

Calcaneal osteotomy; nickel-titanium shape memory alloy; stepped plate; compression stiffness; biomechanics

DOI：

10.7507/1002-1892.201709121

Video：

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ObjectiveTo compare the biomechanical characteristics of self-made nickel-titanium shape memory alloy stepped plate with calcaneal plate and cannulated compression screws in fixing calcaneal osteotomy.MethodsCalcaneal osteotomy was operated on 6 fresh-frozen lower limbs collected from donors. Then three kinds of fixation materials were applied in random, including the self-made nickel-titanium shape memory alloy stepped plate (group A), calcaneal plate (group B), and cannulated compression screws (group C). Immediately after fixation, axial loading of 20-600 N and 20 N/s in speed was introduced to record the biomechanical data including maximum displacement, elastic displacement, and maximum load. Then fatigue test was performed (5 Hz in frequency and repeat 3 000 times) and the same axial loading was introduced to collect the biomechanical data. Finally, the axial compression stiffness before and after fatigue test were calculated.ResultsThere was no significant difference in the axial compression stiffness between pre- and post-fatigue test in each group (P>0.05). However, the axial compression stiffness was significant higher in group A than that in groups B and C both before and after fatigue test (P<0.05). No significant difference was found between group B and group C (P>0.05).ConclusionSelf-made nickel-titanium shape memory alloy stepped plate is better than calcaneal plate and cannulated compression screws in axial load stiffness after being used to fix calcaneal osteotomy.

Citation： BAI Jiyue, XU Yongqing, HE Xiaoqing, LI Chuan, LIU Shuai, LI Liang. Biomechanical comparison of three kinds of fixation instruments for calcaneal osteotomy. Chinese Journal of Reparative and Reconstructive Surgery, 2018, 32(2): 192-194. doi: 10.7507/1002-1892.201709121 Copy

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2.	Atkins RM. The treatment of calcaneal malunion. Foot Ankle Clin, 2014, 19(3): 521-540.
3.	曹琳颖, 许鹤星, 元永学, 等. 成人获得性扁平足的治疗进展. 双足与保健, 2017, 26(7): 104-105.
4.	李博华, 黄富国, 刘雷. 陈旧性跟骨骨折的治疗进展. 中国修复重建外科杂志, 2017, 31(10): 1273-1277.
5.	Boffeli TJ, Abben KW. Double calcaneal osteotomy with percutaneous Steinmann pin fixation as part of treatment for flexible flatfoot deformity: a review of consecutive cases highlighting our experience with pin fixation. J Foot Ankle Surg, 2015, 54(3): 478-482.
6.	陈仲新, 康建华. 解剖钢板和压力螺栓治疗跟骨骨性毁损伤的生物力学稳定性及临床应用研究. 中国医药科学, 2017, 7(1): 151-154.
7.	周望者, 余可和. 空心螺钉与哈勃钉经皮内固定 SandersⅡ型跟骨骨折的生物力学比较. 现代实用医学, 2015, 27(6): 723-724.
8.	Yontar NS, Ogut T, Guven MF, et al. Surgical treatment results for flexible flatfoot in adolescents. Acta Orthop Traumatol Turc, 2016, 50(6): 655-659.
9.	张奉琪, 王慧娟, 张奇, 等. 跟骨内移截骨治疗获得性扁平足临床分析. 中国矫形外科杂志, 2011, 19(3): 192-194.
10.	冯嘉威, 何伟东, 王磊, 等. 下胫腓联合韧带不同程度损伤的稳定性研究. 中华创伤骨科杂志, 2015, 17(7): 609-615.
11.	Marks RM, Parks BG, Schon LC. Midfoot fusion technique for neuroarthropathic feet: biomechanical analysis and rationale. Foot Ankle Int, 1998, 19(8): 507-510.
12.	张睿, 罗鹏, 胡炜, 等. 新型股骨近端内侧支撑钢板治疗股骨反转子间骨折的生物力学研究. 中国修复重建外科杂志, 2017, 31(2): 165-170.
13.	倪明, 黄伟志, 梅炯, 等. 锁定钢板、交叉金属螺钉和可吸收螺钉固定治疗跟骨关节内骨折的生物力学比较. 中国科学（生命科学）, 2016, 46(6): 756-762.
14.	Yu GR, Hu SJ, Yang YF, et al. Reconstruction of calcaneal fracture malunion with osteotomy and subtalar joint salvage: technique and outcomes. Foot Ankle Int, 2013, 34(5): 726-733.
15.	张宏宁, 朱永展, 邹运璇, 等. 保留距下关节的跟骨截骨术治疗跟骨骨折畸形愈合. 实用骨科杂志, 2017, 23(11): 986-990.
16.	Saxena A, Patel R. Medial displacement calcaneal osteotomy: A comparison of screw versus locking plate fixation. J Foot Ankle Surg, 2016, 55(6): 1164-1168.
17.	蔡兴博, 丁晶, 徐永清. 镍钛记忆合金在骨科临床中的应用. 国际骨科学杂志, 2017, 38(6): 364-367.
18.	Hoon QJ, Pelletier MH, Christou C, et al. Biomechanical evaluation of shape-memory alloy staples for internal fixation-an in vitro study. J Exp Orthop, 2016, 3(1): 19.

1. Rosenbaum AJ, Lisella J, Patel N, et al. The cavus foot. Med Clin North Am, 2014, 98(2): 301-312.
2. Atkins RM. The treatment of calcaneal malunion. Foot Ankle Clin, 2014, 19(3): 521-540.
3. 曹琳颖, 许鹤星, 元永学, 等. 成人获得性扁平足的治疗进展. 双足与保健, 2017, 26(7): 104-105.
4. 李博华, 黄富国, 刘雷. 陈旧性跟骨骨折的治疗进展. 中国修复重建外科杂志, 2017, 31(10): 1273-1277.
5. Boffeli TJ, Abben KW. Double calcaneal osteotomy with percutaneous Steinmann pin fixation as part of treatment for flexible flatfoot deformity: a review of consecutive cases highlighting our experience with pin fixation. J Foot Ankle Surg, 2015, 54(3): 478-482.
6. 陈仲新, 康建华. 解剖钢板和压力螺栓治疗跟骨骨性毁损伤的生物力学稳定性及临床应用研究. 中国医药科学, 2017, 7(1): 151-154.
7. 周望者, 余可和. 空心螺钉与哈勃钉经皮内固定 SandersⅡ型跟骨骨折的生物力学比较. 现代实用医学, 2015, 27(6): 723-724.
8. Yontar NS, Ogut T, Guven MF, et al. Surgical treatment results for flexible flatfoot in adolescents. Acta Orthop Traumatol Turc, 2016, 50(6): 655-659.
9. 张奉琪, 王慧娟, 张奇, 等. 跟骨内移截骨治疗获得性扁平足临床分析. 中国矫形外科杂志, 2011, 19(3): 192-194.
10. 冯嘉威, 何伟东, 王磊, 等. 下胫腓联合韧带不同程度损伤的稳定性研究. 中华创伤骨科杂志, 2015, 17(7): 609-615.
11. Marks RM, Parks BG, Schon LC. Midfoot fusion technique for neuroarthropathic feet: biomechanical analysis and rationale. Foot Ankle Int, 1998, 19(8): 507-510.
12. 张睿, 罗鹏, 胡炜, 等. 新型股骨近端内侧支撑钢板治疗股骨反转子间骨折的生物力学研究. 中国修复重建外科杂志, 2017, 31(2): 165-170.
13. 倪明, 黄伟志, 梅炯, 等. 锁定钢板、交叉金属螺钉和可吸收螺钉固定治疗跟骨关节内骨折的生物力学比较. 中国科学（生命科学）, 2016, 46(6): 756-762.
14. Yu GR, Hu SJ, Yang YF, et al. Reconstruction of calcaneal fracture malunion with osteotomy and subtalar joint salvage: technique and outcomes. Foot Ankle Int, 2013, 34(5): 726-733.
15. 张宏宁, 朱永展, 邹运璇, 等. 保留距下关节的跟骨截骨术治疗跟骨骨折畸形愈合. 实用骨科杂志, 2017, 23(11): 986-990.
16. Saxena A, Patel R. Medial displacement calcaneal osteotomy: A comparison of screw versus locking plate fixation. J Foot Ankle Surg, 2016, 55(6): 1164-1168.
17. 蔡兴博, 丁晶, 徐永清. 镍钛记忆合金在骨科临床中的应用. 国际骨科学杂志, 2017, 38(6): 364-367.
18. Hoon QJ, Pelletier MH, Christou C, et al. Biomechanical evaluation of shape-memory alloy staples for internal fixation-an in vitro study. J Exp Orthop, 2016, 3(1): 19.

Chinese Journal of Reparative and Reconstructive Surgery

Biomechanical comparison of three kinds of fixation instruments for calcaneal osteotomy

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