International Center for Orthopaedic Advancement, The Johns Hopkins University, Baltimore, MD, USA.
Foot Ankle Surg. 2013 Dec;19(4):267-72. doi: 10.1016/j.fas.2013.06.009. Epub 2013 Jul 19.
Our goal was to compare diastasis after endobutton and screw fixation after Lisfranc ligament complex sectioning.
Twenty-four (12 pairs) fresh-frozen cadaveric feet were assigned to endobutton or screw fixation and loaded to 343N. Displacement (first-second metatarsal bases) was measured in intact feet and after ligament sectioning (Lisfranc, medial-intermediate cuneiform ligaments), fixation, and 10,000 cycles.
The mean change in diastasis for endobutton and screw fixation under initial loading was 1.0mm (95% CI, 0.2-1.9mm) and 0.0mm (95% CI, -0.4 to 0.4mm), respectively (p=0.017). After cyclic loading, diastasis decreased (mean, -0.7mm, 95% CI, -1.2 to -0.1mm) in the endobutton group but was unchanged in the screw group (p=0.035).
Diastasis after endobutton fixation was significantly greater than after screw fixation under initial loading but did not increase further after cyclic loading.
我们的目标是比较内固定纽扣和螺钉固定后 Lisfranc 韧带复合体切开后的腹侧分离。
将 24 个（12 对）新鲜冷冻的尸体脚分为内固定纽扣或螺钉固定，并在 343N 下加载。在完整的脚上测量位移（第一-第二跖骨基底），然后在韧带切开（Lisfranc、内侧-中间楔骨韧带）、固定以及 10000 次循环后测量。
初始加载时，内固定纽扣和螺钉固定的腹侧分离的平均变化分别为 1.0mm（95%置信区间，0.2-1.9mm）和 0.0mm（95%置信区间，-0.4 至 0.4mm）（p=0.017）。在循环加载后，内固定纽扣组的腹侧分离减少（平均减少 0.7mm，95%置信区间，-1.2 至-0.1mm），但螺钉组无变化（p=0.035）。
在初始加载下，内固定纽扣固定后的腹侧分离明显大于螺钉固定，但在循环加载后没有进一步增加。
