Stabilisation of the syndesmosis in the maisonneuve fracture: A biomechanical study comparing 2-hole locking plate and quadricortical screw fixation

Richard Gardner, Taher Yousri, Fiona Holmes, Damian Clark, Phil Pollintine, Anthony W Miles, Mark Jackson

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

OBJECTIVE:: The aim of this study is to determine whether a two-hole locking plate has biomechanical advantages over conventional screw stabilisation of the syndesmosis in this injury pattern.
METHODS:: Six pairs of fresh-frozen human cadaver lower legs were prepared to simulate an unstable Maisonneuve fracture. Each limb was compared with its pair; the syndesmosis in one being stabilised with two 4.5mm quadricortical cortical screws, the other a two-hole locking plate with 3.2mm locking screws. The limbs were then mounted on a servo-hydraulic testing rig and axially loaded to a peak load of 800N for 12000 cycles. Fibula shortening and diastasis were measured. Each limb was then externally rotated until failure occurred. Failure was defined as fracture of bone or metalwork, syndesmotic widening or axial migration >2mm.
RESULTS:: Both constructs effectively stabilised the syndesmosis during the cyclical loading within 0.1mm of movement. However the locking plate group demonstrated greater resistance to torque compared to quadricortical screw fixation (40.6Nm vs 21.2Nm respectively, p value
Original languageEnglish
Pages (from-to)212-216
JournalJournal of Orthopaedic Trauma
Volume27
Issue number4
DOIs
Publication statusPublished - Apr 2013

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