Biomechanical analysis in using three different implants for midfoot injury
LI Liang,XU Yong-qing,HE Xiao-qing,LI Chuan
Chinese Journal of Clinical Anatomy ›› 2019, Vol. 37 ›› Issue (2) : 179-184.
Biomechanical analysis in using three different implants for midfoot injury
Objective To evaluate the stability of new Nickel titanium memory alloy three-corner fixator in treatment of midfoot injury and measure the changes of plantar pressure of the lateral column dislocation by three different implants to provide experimental reference in selecting implants and evaluate the biomechanical properties of those implants．Methods Six fresh foot specimens were made into the models of the lateral column dislocation，which were fixed with Nickel titanium memory alloy three-corner fixator，the bridge plate and 2mm K-wire in turn. After the loading of 600 N，the changes of the plantar pressure in forefoot were measured by the method of the Tekscan Evolution handle pressure system．During the experiment, axial compression was performed with ElectroForce®3510 series test instruments. The compression stiffness of each bone-fixation combination was calculated and statistically analyzed. Results While the tarsometatarsal joint fracture dislocation was fixated by those there different kind of implants, the pressure under the fourth and fifth tarsometatarsal joints would all increased; the peak pressure under the second and third metatarsal head would all decrease, and differences were statistically significant（P＜0.05）．Nickel titanium memory alloy three-corner showed the statistical significant difference compared with the normal state（P>0.05）. There was no statistically significance between the compression stiffness of the three implants before fatigue test. The compression stiffness of K-wire group was decreased with significance. Conclusion Nickel titanium memory alloy three-corner fixator would help plantar pressure of the forefoot return to the normal state. The stability of the Nickel titanium memory alloy three-corner fixator is favored to meet the special biomechanical needs, which lays the foundation for its clinical use.
Nickel titanium memory alloy three-corner fixator / Midfoot injury； Biomechanical；Plantar pressure
[1] Rosenbaum A, Dellenbaugh S, Dipreta J, et al. Subtle injuries to the lisfranc joint[J]. Orthopedics, 2011, 34(11):882-887.
[2] Buzzard BM, Briggs PJ. Surgical management of acute tarsometatarsal fracture dislocation in the adult[J]. Clin Orthop Relat Res,1998(353):125-133.
[3] Hatem SF. Imaging of lisfranc injury and midfoot sprain[J]. Radiol Clin North Am, 2008, 46(6):1045-1060.
[4] 李春光，俞光荣，李兵，等. 内侧楔骨与第2跖骨底间韧带的解剖研究及临床意义[J]. 中国临床解剖学杂志, 2012, 30(02):119-122.
[5] Panchbhavi VK, Molina DT, Villarreal J, et al. Three-dimensional, digital, and gross anatomy of the Lisfranc ligament[J]. Foot Ankle Int, 2013, 34(6):876-880.
[6] 刘凯， 李义凯， 邵红岩，等. 跗跖关节韧带的解剖观测及其意义[J]. 中国临床解剖学杂志, 2012, 30(2):123-126.
[7] Chiodo CP, Myerson M S. Developments and advances in the diagnosis and treatment of injuries to the tarsometatarsal joint[J]. Orthop Clin North Am, 2001, 32(1):11-20.
[8] Murphy N, Olney D. Lisfranc joint injuries: trauma mechanisms and associated injuries[J]. J Trauma,1994, 36(3):464-465.
[9] Schepers T, Oprel PP, Van Lieshout EM. Influence of approach and implant on reduction accuracy and stability in lisfranc fracture-dislocation at the tarsometatarsal joint[J]. Foot Ankle Int, 2013, 34(5):705-710.
[10]Cressman MR, Pawl RP. Serpentine myelographic defect caused by a redundant nerve root. Case report[J]. J Neurosurg,1968, 28(4):391-393.
[11]Marks RM, Parks BG, Schon LC. Midfoot fusion technique for neuroarthropathic feet: biomechanical analysis and rationale[J]. Foot Ankle Int,1998,19(8):507-510.
[12]Stavlas P, Roberts CS, Xypnitos FN, et al. The role of reduction and internal fixation of Lisfranc fracture-dislocations: a systematic review of the literature[J]. Int Orthop, 2010,34(8):1083-1091.
[13]Castro M, Melao L, Canella C, et al. Lisfranc joint ligamentous complex: MRI with anatomic correlation in cadavers[J]. AJR Am J Roentgenol, 2010,195(6):W447-W455.
[14]Macmahon A, Kim P, Levine D S, et al. Return to sports and physical activities after primary partial arthrodesis for lLisfranc injuries in young patients[J]. Foot Ankle Int, 2016, 37(4):355-362.
[15] Ly TV, Coetzee JC. Treatment of primarily ligamentous Lisfranc joint injuries: primary arthrodesis compared with open reduction and internal fixation. A prospective, randomized study[J]. J Bone Joint Surg Am, 2006, 88(3):514-520.
[16]van Koperen PJ, de Jong VM, Luitse JS, et al. Functional outcomes after temporary bridging with locking plates in Lisfranc injuries[J]. J Foot Ankle Surg, 2016, 55(5):922-926.
[17]李川，徐永清，颜翼，等. 镍钛记忆合金腕骨三角融合器有限元分析[J]. 中国临床解剖学杂志, 2012, 30(6):678-682.
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