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Biomechanical comparison of bionic, screw and Endobutton fixation in the treatment of tibiofibular syndesmosis injuries

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Abstract

Background

The two prevalent fixation methods in the treatment of syndesmosis injuries, the rigid screw fixation and flexible Endobutton fixation, are not without issues; thus, we have designed a novel bionic fixation method which combines the features of both rigid and flexible fixations. The aim of this study was to compare the biomechanical properties of the bionic fixation to the screw and Endobutton fixations.

Methods

Six normal fresh-frozen legs from amputation surgery were used. After initial tests of intact syndesmosis, screw, bionic and Endobutton fixations were performed sequentially for each specimen. Axial loading as well as rotation torque were applied, in five different ankle positions: neutral position, dorsiflexion, plantar flexion, varus, and valgus. The displacement of the syndesmosis and the tibial strain were analysed using a biomechanical testing system.

Results

Whether receiving axial loading or rotation torque, in most situations (neutral position, dorsiflexion, varus, plantar flexion with low loading, valgus with high loading, internal and external rotation), the bionic group and Endobutton group had comparable displacements, and there was no significant difference among the intact, bionic, and Endobutton groups; whereas the displacements of the screw group were smaller than any of the other three groups. Results of the tibial strain were similar with that of the displacement.

Conclusions

The bionic fixation at least equals the performance of Endobutton fixation; it also allows more physiologic movement of the syndesmosis when compared to the screw fixation and may serve as a viable option for the fixation of the tibiofibular syndesmosis.

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Acknowledgments

This study was supported by the Medical Science Research Key Project of Hebei Province, China (ZL20140115). And we thank Xiaolin Zhang, professor of Hebei Medical University, for statistical help in the analysis.

Disclosure

The authors have no financial or other conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Anatomy, Hebei Medical University, No.361 Zhongshan East Road, Chang’an District, Shijiazhuang, Hebei, 050011, China

    Lin Wang, Baozhi Wang & Huixian Cui

  2. Trauma Emergency Center, The Third Hospital of Hebei Medical University, Hebei Province, Shijiazhuang, 050051, China

    Lin Wang, Zhaohui Song & Yingze Zhang

  3. Department of Orthopaedics, The Third Hospital of Hebei Medical University, Hebei Province, Shijiazhuang, 050051, China

    Guohui Xu

  4. Orthopaedic Research Institute of Hebei Province & Key Laboratory of Orthopaedic Biomechanics of Hebei Province, No.139 Ziqiang Road, Qiaoxi District, Shijiazhuang, Hebei, 050051, China

    Lin Wang, Zhaohui Song & Yingze Zhang

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  1. Lin Wang
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  2. Baozhi Wang
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  3. Guohui Xu
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  4. Zhaohui Song
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  5. Huixian Cui
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Corresponding authors

Correspondence to Huixian Cui or Yingze Zhang.

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Wang, L., Wang, B., Xu, G. et al. Biomechanical comparison of bionic, screw and Endobutton fixation in the treatment of tibiofibular syndesmosis injuries. International Orthopaedics (SICOT) 40, 307–314 (2016). https://doi.org/10.1007/s00264-015-2920-6

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  • DOI: https://doi.org/10.1007/s00264-015-2920-6

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