Determining the rotational strength of Lateral Malleolus Locking Plate versus Fibula Intramedullary nail in Supination External Rotation type IV injuries: cadaveric study

[摘要] Introduction: Open reduction and internal fixation (ORIF) with anatomical reduction ofdisplaced ankle fractures have been the standard of care since the 1960, but are associatedwith increased risk of complication, especially wound dehiscence and infections. Studiesshowed that minimal invasive ankle fracture fixation with a fibula intramedullary nail can reducethese complications with good clinical results after fracture fixation. Biomechanical evidence ofits strength compared with locking plates and screws, is currently limited.Aims: We examined the biomechanical properties of a distal fibular locking plate with the fibulaintramedullary nail for fixation of ankle fractures induced in cadaveric models. Methods: 14cadavers (28 limbs) were used and supination external rotation (SER) IV injury was surgicallycreated. Right limbs was allocated to the locking plate group and left limbs to the intramedullaryfibula nail group. Biomechanical testing was performed simulating an external rotation force.Results: There was no statistical difference between the mean force needed for loss ofanatomical reduction in the locking plate group and fibula nail group. There was, however, astatistical difference between the mean forces for total implant failure between the locking plategroup and fibula nail group.Conclusion: This cadaver study supports previous biomechanical research findings ofcomparable stability between the two surgical techniques when looking at the force needed tocause loss of anatomical reduction. The locking plates, was however superior to the fibula nail with regards to the amount of force needed to cause implant failure. From a biomechanicalperspective, this showed that the fibula nail is be a viable option when treating unstable fibulafractures.

[发布机构] University of the Free State