Biomechanical evaluation of reconstruction plates with locking, nonlocking, and hybrid screws configurations in calcaneal fracture: a finite element model study
Calcaneal fractures are the most common fractures of the tarsal bones. The stability of fixation is an important factor for successful reconstruction of calcaneal fractures. The purpose of this study was to analyze the biomechanical influence of plate fixation with different combinations of locking and nonlocking screws during early weight-bearing phase. A three-dimensional FE foot model was established using ANSYS software, which comprised bones, cartilages, plantar fascia, and soft tissue. Calcaneal plate was fixed with whole locking (WLS), whole nonlocking (WNS), and hybrid screw configurations for FE analysis. The WNS generated a 6.1° and 2.2° Bohler angle decrease compared with the intact model and WLS (WNS: 18.9; WLS: 21.1; intact: 25.0°). Some hybrid screw configurations (Bohler angle: 21.5° and 21.2°) generated stability similar to WLS. The FE results showed that the fragments at the posterior facet and the posterior tuberosity sustained more stress. This study recommends that the hybrid screw configuration with at least four locking screws, two at the posterior facet fragment and two at the posterior tuberosity fragment, is the optimal choice for the fixation of Sanders type IIB calcaneal fractures.
KeywordsBiomechanics Calcaneal fracture Sanders IIB Finite element analysis Locking plate Nonlocking plate Hybrid configuration
- 7.Coughlin MJ, Mann RA, Saltzman CL, Anderson RB (2007) Surgery of the foot and ankle. Mosby Inc, Philadelphia, PAGoogle Scholar
- 8.Hirschmüller A, Konstantinidis L, Baur H, Müller S, Mehlhorn A, Kontermann J, Grosse U, Südkamp N, Helwig P (2011) Do changes in dynamic plantar pressure distribution, strength capacity and postural control after intra-articular calcaneal fracture correlate with clinical and radiological outcome? Injury 42:1135–1143CrossRefPubMedGoogle Scholar
- 17.Nakamura S, Crowninshield R, Cooper R (1980) An analysis of soft tissue loading in the foot—a preliminary report. Bull Prosthet Res 10:27–34Google Scholar
- 25.Simkin A (1982) Structural analysis of the human foot in standing posture. Tel-Aviv University, Tel-AvivGoogle Scholar