scholarly journals Biomechanical Evaluation of Tarsometatarsal Fusion Comparing Crossing Lag Screws and Lag Screw With Locking Plate

2021 ◽  
pp. 107110072110335
Author(s):  
Sarah Ettinger ◽  
Lisa-Christin Hemmersbach ◽  
Michael Schwarze ◽  
Christina Stukenborg-Colsman ◽  
Daiwei Yao ◽  
...  
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Operative Procedure ◽  
Fixation Technique ◽  
Lag Screw ◽  
Group 15 ◽  
Fresh Frozen ◽  
Biomechanical Evaluation ◽  
The Stability ◽  
End Stage

Background: Tarsometatarsal (TMT) arthrodesis is a common operative procedure for end-stage arthritis of the TMT joints. To date, there is no consensus on the best fixation technique for TMT arthrodesis and which joints should be included. Methods: Thirty fresh-frozen feet were divided into one group (15 feet) in which TMT joints I-III were fused with a lag screw and locking plate and a second group (15 feet) in which TMT joints I-III were fused with 2 crossing lag screws. The arthrodesis was performed stepwise with evaluation of mobility between the metatarsal and cuneiform bones after every application or removal of a lag screw or locking plate. Results: Isolated lag-screw arthrodesis of the TMT I-III joints led to significantly increased stability in every joint ( P < .05). Additional application of a locking plate caused further stability in every TMT joint ( P < .05). An additional crossed lag screw did not significantly increase rigidity of the TMT II and III joints ( P > .05). An IM screw did not influence the stability of the fused TMT joints. For TMT III arthrodesis, lag-screw and locking plate constructs were superior to crossed lag-screw fixation ( P < .05). TMT I fusion does not support stability after TMT II and III arthrodesis. Conclusion: Each fixation technique provided sufficient stabilization of the TMT joints. Use of a lag screw plus locking plate might be superior to crossed screw fixation. An additional TMT I and/or III arthrodesis did not increase stability of an isolated TMT II arthrodesis. Clinical Relevance: We report the first biomechanical evaluation of TMT I-III arthrodesis. Our results may help surgeons to choose among osteosynthesis techniques and which joints to include in performing arthrodesis of TMT I-III joints.

scholarly journals Supplementary medial locking plate fixation of Ludloff osteotomy versus sole lag screw fixation: A biomechanical evaluation

2017 ◽  
Vol 47 ◽  
pp. 66-72
Author(s):  
Panagiotis E. Chatzistergos ◽  
George C. Karaoglanis ◽  
Stavros K. Kourkoulis ◽  
Minos Tyllianakis ◽  
Emmanouil D. Stamatis
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Plate Fixation ◽  
Locking Plate Fixation ◽  
Lag Screw ◽  
Biomechanical Evaluation

scholarly journals The Fibular Intramedullary Nail Versus Locking Plate and Lag Screw Fixation in the Management of Unstable Elderly Ankle Fractures: A Cadaveric Biomechanical Comparison

2020 ◽  
Vol 34 (11) ◽  
pp. e401-e406
Author(s):  
Thomas H. Carter ◽  
Robert Wallace ◽  
Samuel A. Mackenzie ◽  
William M. Oliver ◽  
Andrew D. Duckworth ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Locking Plate ◽  
Screw Fixation ◽  
Ankle Fractures ◽  
Lag Screw ◽  
Biomechanical Comparison

Interfragmentary lag screw fixation in locking plate constructs increases stiffness in simple fracture patterns

2015 ◽  
Vol 30 (8) ◽  
pp. 814-819 ◽  
Author(s):  
Sven Märdian ◽  
Werner Schmölz ◽  
Klaus-Dieter Schaser ◽  
Georg N. Duda ◽  
Mark Heyland
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Lag Screw ◽  
Fracture Patterns ◽  
Simple Fracture

scholarly journals First Metatarsalphalangeal Joint Arthrodesis: A Retrospective Comparison of Two Methods of Fixation

2015 ◽  
Vol 9 (1) ◽  
pp. 480-482 ◽  
Author(s):  
M.A Rashid ◽  
M Parnell ◽  
W.S Khan ◽  
A Khan
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Fixation Method ◽  
Compression Screw ◽  
Clinical Criteria ◽  
Non Union ◽  
Lag Screw ◽  
Retrospective Comparison ◽  
Significant Difference ◽  
Interfragmentary Compression

First metatarsalphalangeal joint arthrodesis is a well established and successful treatment; however there still remains controversy over the best choice of construct. We performed a retrospective study of patients undergoing first metatarsalphalangeal fusion over eighteen months (n=52) using either dorsal non-locking plate with additional compression lag screw fixation or dorsal non-locking plate alone. We found when assessing clinical criteria, patients with dorsal non-locking plates and additional compression lag screw fixation had a significantly higher rate of fusion (100% vs 77.8%), significantly higher rate of fusion within the first two months (55.6% vs 83.3%), significantly earlier time to fusion (52.2 days vs 75.6 days), and significantly lower rate of non-union (0% vs 22.2%). When blindly assessing radiographic criteria, the patients treated with the plate and compression screw had a significantly higher rate of fusion and lower rate of non-union (0% vs 33%). There was no statistically significant difference between the frequencies of complications in the groups. We believe that the interfragmentary compression is a crucial factor in achieving good union rates and recommend the use of non-locking pre-contoured plating with additional interfragmentary compression screw as the fixation method of choice for these procedures.

Screw Fixation Compared to H-Locking Plate Fixation for First Metatarsocuneiform Arthrodesis: A Biomechanical Study

2005 ◽  
Vol 26 (11) ◽  
pp. 984-989 ◽  
Author(s):  
David A. Cohen ◽  
Brent G. Parks ◽  
Lew C. Schon
Keyword(s):  
Locking Plate ◽  
Mechanical Design ◽  
Screw Fixation ◽  
Plate Fixation ◽  
Biomechanical Study ◽  
Maximal Load ◽  
Load To Failure ◽  
Fresh Frozen ◽  
The Mean ◽  
Eden Prairie

Background: Several different techniques have been used for fixation of first metatarsocuneiform (MTC) joint arthrodesis, a standard treatment for arthritis, instability, and deformity of the MTC joint. Improved plating systems using locking designs are now available, but no studies have yet compared this construct with other methods. We compared load to failure with a locking plate design versus standard crossed-screw fixation. Methods: Ten matched pairs of fresh frozen cadaver feet were used. The bone density of each pair was measured with DEXA scanning. One foot of each pair was randomly assigned to have a dorsomedial Normed H titanium locking plate (Normed Medizin-Technik Vertriebs-GmbH, D-78501 Tuttlingen, Germany) applied to the first MTC joint. On the other foot of the pair, fixation of the first MTC joint was done with crossed ACE DePuy 4.0 (DePuy/Ace, Warsaw, IN) titanium cannulated screws. The first metatarsal and first cuneiform were then isolated and planted in an epoxy resin. The specimens were loaded to failure in a four-point bending configuration using a MTS Mini Bionix test frame (MTS Systems Corp., Eden Prairie, MN). Failure was defined as displacement of more than 3 mm at the arthrodesis site. The Student t-test was used to determine any observed differences, with significance set at p ≤ 0.05. Results: The mean maximal load to failure was 140.08 N (SD ± 77.1) for screw fixation alone and 58.09 N (SD ± 11.86) for the H-locking plate. This difference was statistically significant ( p = 0.008). The mean stiffness of the construct for screw fixation alone was 83.10 N/mm (SD ± 49.8) and 19.96 N/mm for the H-locking plate. This difference also was statistically significant ( p = 0. 004). Conclusion: Screw fixation for first MTC arthrodesis created a stronger and stiffer construct than did the H-locking plate. This was likely due to the mechanical design of the implants. Compression across the MTC joint could be applied with the screws, but the plate relied on a fixed angle design with no compression.

The modified Lapidus Arthrodesis with a plantar locking plate and additional lag screw fixation

2016 ◽  
Vol 22 (2) ◽  
pp. 71
Author(s):  
J. Dohle ◽  
A. Marques ◽  
B. Spreigner ◽  
T. Busch
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Lag Screw

scholarly journals Outcomes of First Metatarsophalangeal Joint Fusion in Patients with Greater Than Fifteen Percent Intermetatarsal Angle. Is Lag Screw Essential?

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0003
Author(s):  
Ashish Shah ◽  
Parke Hudson ◽  
Ibukunoluwa Araoye ◽  
Zachariah Pinter ◽  
Girish Motwani ◽  
...  
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Metatarsophalangeal Joint ◽  
Dorsal Plate ◽  
Chi Square ◽  
First Metatarsophalangeal Joint ◽  
Lag Screw ◽  
Wide Range ◽  
Significant Difference ◽  
Student’S T

Category: Midfoot/Forefoot Introduction/Purpose: Metatarsophalangeal arthrodesis has usually been performed using a dorsal plate to immobilize the MTP joint with or without lag screw fixation. Data in the literature is sparse on outcomes of dorsal plate plus lag screw fixation, especially in patients with IMA greater than 15 percent. Our objective was to compare IMA correction outcomes and union rates between dorsal plate only fusions and dorsal plate plus lag screw fixation in patients with IMA greater than 15 percent. Methods: We retrospectively reviewed the charts of 36 patients (39 feet) who underwent first MTP joint arthrodesis for moderate to severe HV deformity between 2011 and 2015. Average age was 61 (range, 39 to 84) years. There were 24 females and 12 males. A single surgeon performed all operations. Joints were immobilized postoperatively using either dorsal locking plate alone or dorsal locking plate with a lag screw. Union (at least 3 bridging cortices) was determined radiographically at 6 weeks, 3 months, 6 months and yearly. All suspect nonunions were examined with CT. Other radiographic parameters examined included preoperative and postoperative hallux valgus, intermetatarsal, and dorsiflexion angles (HVA, IMA, and DFA respectively). Student’s t test was used to compare group means while Pearson’s Chi square test was used to compare group rates. Results: Overall union rate was 82.1% (32/39). There was no significant difference in union rates between the two groups (dorsal plate only = 81.5% (22/27), dorsal plate plus lag screw group = 83.3% (10/12)) (P > 0.05). Average follow-up was 9 (range 7 to 35) months. Overall, the average IMA correction was 4.7 (preoperative = 17.8, postoperative = 13.1) degrees. Average IMA corrections were 4.7 and 4.54 degrees in the dorsal plate only group and dorsal plate plus lag screw groups respectively. Overall, average HVA correction was 21 (preoperative = 39.5, postoperative = 18.5) degrees. Conclusion: Our findings indicate that there is no difference in the fusion rates between both patient groups with IMA greater than fifteen percent. Because other published studies have a wide range of IMAs preoperatively, our study represents more attainable goals in patients with severe (IMA greater than 15%) deformities. In addition, our findings suggest that in such patients, MTP arthrodesis may not be sufficient as a standalone procedure for correction of IMA. Additional proximal osteotomy may be required for correction of the IMA.

Trans-ilial and transsacral brace fixation of sacral fractures and sacro-iliac luxations (seven cases)

2004 ◽  
Vol 17 (04) ◽  
pp. 210-215 ◽  
Author(s):  
R. B. Fitch ◽  
S. T. Kudnig
Keyword(s):  
Screw Fixation ◽  
Primary Repair ◽  
Sacral Fracture ◽  
Sacral Fractures ◽  
Lag Screw ◽  
Radiographic Parameters ◽  
Concurrent Use ◽  
The Stability

SummaryTrans-ilial brace fixation was used as the primary repair of two sacral fractures and in conjunction with a trans-sacral pin for the repair of a bilateral sacro-iliac luxation and a sacral fracture with contralateral sacroiliac luxation. Trans-ilial brace fixation was also used as a secondary fixation for two unilateral sacro-iliac luxations and a bilateral sacro-iliac luxation. Follow-up radiographic parameters were compared to post-operative radiographic parameters to assess the stability of the fixation and the progression of healing. There was not any morbidity associated with the trans-ilial brace technique and all of the cases healed uneventfully. Indications for the use of the trans-ilial brace include sacro-iliac injuries where an additional means of stability may be indicated, comminuted sacral fractures in which the landmarks for lag screw fixation are obscured and bilateral sacro-iliac injuries with the concurrent use of a trans-sacral pin.

scholarly journals Stability of two anterior fixations for three-column injury in the lower cervical spine: biomechanical evaluation of anterior pedicle screw-plate fixation

2018 ◽  
Vol 46 (4) ◽  
pp. 1455-1460
Author(s):  
Hai-hao Wu ◽  
Tao Tang ◽  
Xiao Yu ◽  
Qing-jiang Pang
Keyword(s):  
Cervical Spine ◽  
Pedicle Screw ◽  
Plate Fixation ◽  
Primary Stability ◽  
Lower Cervical Spine ◽  
Intact State ◽  
Fresh Frozen ◽  
Biomechanical Evaluation ◽  
The Stability ◽  
Injury Models

Objectives This study aimed to evaluate the stability of anterior pedicle screw-plate (APSP) fixation and anterior vertebral body screw-plate (AVBSP) fixation for three-column injury in the lower cervical spine. Methods Six fresh-frozen human cadaveric specimens of the lower cervical spine were prepared. After measurement of the range of motion (ROM) in the intact state, the specimens were prepared as three-column injury models. The models were stabilized by AVBSP or APSP fixation. The ROM of the models in the two states was measured. The ROM in the two states was compared. Results The ROM of the intact state in all directions was significantly smaller than that of the AVBSP state and significantly larger than that of the APSP state. The ROM of the AVBSP state in all directions was significantly larger than that of the APSP state. Conclusions This study shows that APSP fixation can provide sufficient stability for three-column injury in the lower cervical spine. The primary stability of our models using APSP fixation is superior to that of AVBSP fixation. These results suggest that APSP can be used for three-column injury in the lower cervical spine.

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