• Something wrong with this record ?

Biomechanical comparison of screw position in variable angle locking plate in intra-articular calcaneal fractures: Cadaveric and radiologic study

V. Baba, L. Capek, L. Kopp, V. Bittner

. 2025 ; 125 (-) : 106534. [pub] 20250423

Language English Country England, Great Britain

Document type Journal Article, Comparative Study

Persistent link   https://www.medvik.cz/link/bmc25015844

BACKGROUND: Lateral plating of calcaneal fractures using variable-angle locking plates is still the golden standard for severely comminuted cases. The aim of this study is to explore the possibilities of improving stability of osteosynthesis by changing screw directions. It provides an assessment and comparison of cadaveric biomechanical experiment with retrospective radiologic data analysis. METHODS: In the cadaveric study 8 intact calcaneus-talus specimens were obtained from 4 deceased donors. Fracture type 2b according to Sanders' classification was created in each specimen and fixed with variable-angle locking plate. The specimens were divided in 2 groups differing in orientation of anterior screws and fixed in PMMA base. A push-in test was performed by a two-column testing machine until gross failure. Retrospective cohort study was performed, reviewing data of 74 patients which underwent surgical treatment of calcaneal fractures with the same construct. Evaluation was performed at scheduled CT and X-Ray controls. Direction of inserted screws and implant failure were noted. FINDINGS: The cadaveric study proved that there is no significant difference in mean failure force between two abovementioned screw configurations in Sanders 2b fracture. A significant difference was observed in initial stiffness. The radiologic retrospective study showed that difference in screw position within all fracture types but type 2b is significant. INTERPRETATION: Screw configuration in the anterior part of variable-angle locking plate appears to affect primary stiffness and stability of the construct. Particularly in more comminuted fractures, screw inserted in the direction of sustentaculum improves the stability and lowers risk of implant failure.

References provided by Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc25015844
003      
CZ-PrNML
005      
20250731091255.0
007      
ta
008      
250708e20250423enk f 000 0|eng||
009      
AR
024    7_
$a 10.1016/j.clinbiomech.2025.106534 $2 doi
035    __
$a (PubMed)40288301
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a enk
100    1_
$a Baba, Vit $u Dep. of Traumatology, Masaryk Hospital in Usti and Labem, Czech Republic; 2(nd) medical faculty, Charles university in Prague, Czech Republic
245    10
$a Biomechanical comparison of screw position in variable angle locking plate in intra-articular calcaneal fractures: Cadaveric and radiologic study / $c V. Baba, L. Capek, L. Kopp, V. Bittner
520    9_
$a BACKGROUND: Lateral plating of calcaneal fractures using variable-angle locking plates is still the golden standard for severely comminuted cases. The aim of this study is to explore the possibilities of improving stability of osteosynthesis by changing screw directions. It provides an assessment and comparison of cadaveric biomechanical experiment with retrospective radiologic data analysis. METHODS: In the cadaveric study 8 intact calcaneus-talus specimens were obtained from 4 deceased donors. Fracture type 2b according to Sanders' classification was created in each specimen and fixed with variable-angle locking plate. The specimens were divided in 2 groups differing in orientation of anterior screws and fixed in PMMA base. A push-in test was performed by a two-column testing machine until gross failure. Retrospective cohort study was performed, reviewing data of 74 patients which underwent surgical treatment of calcaneal fractures with the same construct. Evaluation was performed at scheduled CT and X-Ray controls. Direction of inserted screws and implant failure were noted. FINDINGS: The cadaveric study proved that there is no significant difference in mean failure force between two abovementioned screw configurations in Sanders 2b fracture. A significant difference was observed in initial stiffness. The radiologic retrospective study showed that difference in screw position within all fracture types but type 2b is significant. INTERPRETATION: Screw configuration in the anterior part of variable-angle locking plate appears to affect primary stiffness and stability of the construct. Particularly in more comminuted fractures, screw inserted in the direction of sustentaculum improves the stability and lowers risk of implant failure.
650    _2
$a lidé $7 D006801
650    12
$a kostní destičky $7 D001860
650    12
$a patní kost $x chirurgie $x diagnostické zobrazování $x zranění $7 D002111
650    12
$a kostní šrouby $7 D001863
650    _2
$a mrtvola $7 D002102
650    _2
$a mužské pohlaví $7 D008297
650    _2
$a ženské pohlaví $7 D005260
650    _2
$a biomechanika $7 D001696
650    _2
$a lidé středního věku $7 D008875
650    12
$a vnitřní fixace fraktury $x metody $x přístrojové vybavení $7 D005593
650    _2
$a retrospektivní studie $7 D012189
650    _2
$a senioři $7 D000368
650    _2
$a dospělí $7 D000328
650    12
$a fraktury kostí $x chirurgie $x diagnostické zobrazování $x patofyziologie $7 D050723
650    12
$a intraartikulární fraktury $x chirurgie $x diagnostické zobrazování $x patofyziologie $7 D057072
650    _2
$a radiografie $7 D011859
650    _2
$a senioři nad 80 let $7 D000369
655    _2
$a časopisecké články $7 D016428
655    _2
$a srovnávací studie $7 D003160
700    1_
$a Capek, Lukas $u Dep. of Clinical Biomechanics, Regional Hospital in Liberec, Czech Republic; Dep. of Technology and Structure, Technical University of Liberec, Czech Republic. Electronic address: lukas.capek@nemlib.cz
700    1_
$a Kopp, Lubomir $u Dep. of Traumatology, Masaryk Hospital in Usti and Labem, Czech Republic; 2(nd) medical faculty, Charles university in Prague, Czech Republic
700    1_
$a Bittner, Vaclav $u Department of Mathematics, Technical University of Liberec, Czech Republic
773    0_
$w MED00001120 $t Clinical biomechanics $x 1879-1271 $g Roč. 125 (20250423), s. 106534
856    41
$u https://pubmed.ncbi.nlm.nih.gov/40288301 $y Pubmed
910    __
$a ABA008 $b sig $c sign $y - $z 0
990    __
$a 20250708 $b ABA008
991    __
$a 20250731091250 $b ABA008
999    __
$a ok $b bmc $g 2366580 $s 1252969
BAS    __
$a 3
BAS    __
$a PreBMC-MEDLINE
BMC    __
$a 2025 $b 125 $c - $d 106534 $e 20250423 $i 1879-1271 $m Clinical biomechanics $n Clin Biomech (Bristol) $x MED00001120
LZP    __
$a Pubmed-20250708
Back

Find record

Citation metrics

Archiving options