Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Jul 1998
Comparative StudyPlacement of screws in the sustentaculum tali. A calcaneal fracture model.
Current methods of treating calcaneus fractures vary greatly, and many techniques of internal fixation have been described. The study of these fractures has been limited in part by the lack of a suitable laboratory model. In this study, a new cadaveric model of calcaneus fractures was developed, using a combination of osteotomies and impaction. ⋯ Stiffness and energy to failure were significantly greater and Bohler's angle significantly less compromised in Group B. It was concluded that the position of the articular fragment of comminuted calcaneal fractures will be maintained at higher loads when the screws in the posterior facet are incorporated into the lateral plate. The model of calcaneal fractures described in this study may be suitable for examining other aspects of fixation.
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Clin. Orthop. Relat. Res. · Jul 1998
Comparative StudyBiomechanical evaluation of transverse acetabular fracture fixation.
The purpose of this two-part biomechanical study was to evaluate various fixation methods for transverse acetabular fractures in a synthetic pelvic model. In Part 1, 40 transverse acetabular fractures were repaired with anterior column plating using 10-hole curved reconstructions plates with one of four screw configurations to evaluate the effect of screw placement and number on fracture fixation stiffness. In Part 2, 36 transverse acetabular fractures were repaired with one of six fixation methods using combinations of contoured plates and column screws to stabilize the anterior column, the posterior column, or both. ⋯ The stiffest construct combined a posterior column plate with an anterior column screw. Because no significant change in stiffness occurred with the addition of a third set of screws, two screws on each side of the fracture site appear to provide sufficient stability with acetabular plating. Concurrent fixation of anterior and posterior columns of transverse acetabular fractures provides the greatest resistance to postoperative loss of reduction in this model.