Pilon fractures are a result of high energy impacts to the ankle joint causing comminution to the tibia. Open reduction and internal fixation is the current method of treatment, which involves reducing the fracture and placing an anterolateral or medial plate along the tibia to secure the bone fragments during the bone healing process, but these have frequent complications for patients. No previous studies have investigated the biomechanical performance of these plates using a model that consists of the tibia, fibula and the syndesmotic tissue. The purpose of this study was to evaluate the biomechanical effectiveness of these plates using cadaveric specimens.
Eight pairs of cadaveric specimens were anatomically aligned and potted proximally. A typical fracture pattern was created in each specimen and then one from each pair treated with an anterolateral and the other with a medial plate. A materials testing machine applied an axial load to the specimen to determine the construct stiffness, followed by a ramp load to failure. An optical tracking system was configured to track the motion of the bone fragments in 3D space. The medial plates tended to provide superior results when compared to the anterolateral plate; however, no statistical difference was found.
This represents the most complex fracture and comprehensive evaluation of the plating options available for this type of injury and may inform surgeons to help reduce the poor outcomes for patients. / Thesis / Master of Applied Science (MASc) / Severe distal tibial fractures (pilon fractures) occur during motor vehicle collisions and falls from a height and are typically treated with one of two fracture fixations. The evidence supporting the use of the fracture fixations is limited and research has yet to be done using cadaveric specimens.
To assess the fracture fixations, six cadaveric specimens were subjected to compressive loading to determine the stiffness. An orthopaedic surgeon then simulated a pilon fracture and repaired each specimen with one of the two fixations. The specimens were then subjected to compressive loading to determine the repaired stiffness and then loaded until failure. During failure testing, an optical tracking system was used to assess the overall motion of the fracture fragments.
Based on preliminary results from stiffness, strength, and relative motion evaluations, the medial plate showed superior results; however, the differences were not found to be statistically significant.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/24810 |
| Date | January 2019 |
| Creators | Kohut, Marisa |
| Contributors | Quenneville, Cheryl, Biomedical Engineering |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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