Wang Chunliang, Liu Shih-Jung, Chang Chung-Hsun
Material Department, Imperial College London, London, UK.
Department of Mechanical Engineering, Chang Gung University, Taoyuan City, Taiwan.
Bone Joint Res. 2023 Aug 23;12(8):504-511. doi: 10.1302/2046-3758.128.BJR-2023-0060.R1.
This study aimed to establish the optimal fixation methods for calcaneal tuberosity avulsion fractures with different fragment thicknesses in a porcine model.
A total of 36 porcine calcanea were sawed to create simple avulsion fractures with three different fragment thicknesses (5, 10, and 15 mm). They were randomly fixed with either two suture anchors or one headless screw. Load-to-failure and cyclic loading tension tests were performed for the biomechanical analysis.
This biomechanical study predicts that headless screw fixation is a better option if fragment thickness is over 15 mm in terms of the comparable peak failure load to suture anchor fixation (headless screw: 432.55 N (SD 62.25); suture anchor: 446.58 N (SD 84.97)), and less fracture fragment displacement after cyclic loading (headless screw: 3.94 N (SD 1.76); suture anchor: 8.68 N (SD 1.84)). Given that the fragment thickness is less than 10 mm, suture anchor fixation is a safer option.
Fracture fragment thickness helps in making the decision of either using headless screw or suture anchor fixation in treating calcaneal tuberosity avulsion fracture, based on the regression models of our study.
本研究旨在通过猪模型确定不同骨折块厚度的跟骨结节撕脱骨折的最佳固定方法。
将36块猪跟骨锯开，制造出三种不同骨折块厚度（5毫米、10毫米和15毫米）的单纯撕脱骨折。将它们随机用两枚缝线锚钉或一枚无头螺钉固定。进行破坏载荷和循环加载拉伸试验以进行生物力学分析。
这项生物力学研究预测，如果骨折块厚度超过15毫米，就破坏载荷峰值而言，无头螺钉固定与缝线锚钉固定相当（无头螺钉：432.55牛（标准差62.25）；缝线锚钉：446.58牛（标准差84.97）），且循环加载后骨折块位移更小（无头螺钉：3.94牛（标准差1.76）；缝线锚钉：8.68牛（标准差1.84）），则无头螺钉固定是更好的选择。若骨折块厚度小于10毫米，缝线锚钉固定是更安全的选择。
根据我们研究的回归模型，骨折块厚度有助于在治疗跟骨结节撕脱骨折时决定使用无头螺钉还是缝线锚钉固定。
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