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.	曹琳穎, 許鶴星, 元永學, 等. 成人獲得性扁平足的治療進展. 雙足與保健, 2017, 26(7): 104-105.
4.	李博華, 黃富國, 劉雷. 陳舊性跟骨骨折的治療進展. 中國修復重建外科雜志, 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.	陳仲新, 康建華. 解剖鋼板和壓力螺栓治療跟骨骨性毀損傷的生物力學穩定性及臨床應用研究. 中國醫藥科學, 2017, 7(1): 151-154.
7.	周望者, 余可和. 空心螺釘與哈勃釘經皮內固定 SandersⅡ型跟骨骨折的生物力學比較. 現代實用醫學, 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.	張奉琪, 王慧娟, 張奇, 等. 跟骨內移截骨治療獲得性扁平足臨床分析. 中國矯形外科雜志, 2011, 19(3): 192-194.
10.	馮嘉威, 何偉東, 王磊, 等. 下脛腓聯合韌帶不同程度損傷的穩定性研究. 中華創傷骨科雜志, 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.	張睿, 羅鵬, 胡煒, 等. 新型股骨近端內側支撐鋼板治療股骨反轉子間骨折的生物力學研究. 中國修復重建外科雜志, 2017, 31(2): 165-170.
13.	倪明, 黃偉志, 梅炯, 等. 鎖定鋼板、交叉金屬螺釘和可吸收螺釘固定治療跟骨關節內骨折的生物力學比較. 中國科學（生命科學）, 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.	張宏寧, 朱永展, 鄒運璇, 等. 保留距下關節的跟骨截骨術治療跟骨骨折畸形愈合. 實用骨科雜志, 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.	蔡興博, 丁晶, 徐永清. 鎳鈦記憶合金在骨科臨床中的應用. 國際骨科學雜志, 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. 曹琳穎, 許鶴星, 元永學, 等. 成人獲得性扁平足的治療進展. 雙足與保健, 2017, 26(7): 104-105.
4. 李博華, 黃富國, 劉雷. 陳舊性跟骨骨折的治療進展. 中國修復重建外科雜志, 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. 陳仲新, 康建華. 解剖鋼板和壓力螺栓治療跟骨骨性毀損傷的生物力學穩定性及臨床應用研究. 中國醫藥科學, 2017, 7(1): 151-154.
7. 周望者, 余可和. 空心螺釘與哈勃釘經皮內固定 SandersⅡ型跟骨骨折的生物力學比較. 現代實用醫學, 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. 張奉琪, 王慧娟, 張奇, 等. 跟骨內移截骨治療獲得性扁平足臨床分析. 中國矯形外科雜志, 2011, 19(3): 192-194.
10. 馮嘉威, 何偉東, 王磊, 等. 下脛腓聯合韌帶不同程度損傷的穩定性研究. 中華創傷骨科雜志, 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. 張睿, 羅鵬, 胡煒, 等. 新型股骨近端內側支撐鋼板治療股骨反轉子間骨折的生物力學研究. 中國修復重建外科雜志, 2017, 31(2): 165-170.
13. 倪明, 黃偉志, 梅炯, 等. 鎖定鋼板、交叉金屬螺釘和可吸收螺釘固定治療跟骨關節內骨折的生物力學比較. 中國科學（生命科學）, 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. 張宏寧, 朱永展, 鄒運璇, 等. 保留距下關節的跟骨截骨術治療跟骨骨折畸形愈合. 實用骨科雜志, 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. 蔡興博, 丁晶, 徐永清. 鎳鈦記憶合金在骨科臨床中的應用. 國際骨科學雜志, 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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