Henry Kuestermann1, Sarah Ettinger2, Daiwei Yao3, Michael Schwarze4, Christian Plaass5, Christina Stukenborg-Colsman6, Leif Claassen7. 1. Diakovere Annastift - Orthopedic Department of the Hannover Medical School (MHH), Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany. Electronic address: henry.a.v.kuestermann@stud.mh-hannover.de. 2. Diakovere Annastift - Orthopedic Department of the Hannover Medical School (MHH), Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany. Electronic address: sarah.ettinger@diakovere.de. 3. Diakovere Annastift - Orthopedic Department of the Hannover Medical School (MHH), Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany. Electronic address: daiwei.yao@diakovere.de. 4. Laboratory for Biomechanics and Biomaterials of the Hannover Medical School, Haubergstrasse 3, 30625 Hannover, Germany. Electronic address: schwarze.michael@mh-hannover.de. 5. Diakovere Annastift - Orthopedic Department of the Hannover Medical School (MHH), Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany. Electronic address: christian.plaass@diakovere.de. 6. Diakovere Annastift - Orthopedic Department of the Hannover Medical School (MHH), Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany. Electronic address: christina.stukenborg@diakovere.de. 7. Diakovere Annastift - Orthopedic Department of the Hannover Medical School (MHH), Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany. Electronic address: leif.claassen@diakovere.de.
Abstract
BACKGROUND: There have been no biomechanical evaluations of naviculocuneiform (NC) joint fixation. This study compared biomechanically 3 different fixation constructs for NC-1-3 joint fixation. METHODS: The present study compared the three fixation constructs lag screw with locking plate for each NC joint, two crossed lag screws for each NC joint and a separate lag screw for each NC joint with bridging locking plates. NC-1-3 fixation was performed stepwise, and rotation of each joint was evaluated after the application of each lag screw or locking plate and their removal. RESULTS: All examined fixation techniques led to a significant reduced rotation of the NC joints. For NC-1 rotation decreased from 2.8° (Range 1.2-6.6°) to 0.6° (0.2-3.0°) for lag screw and locking plate (p = 0.002) and from 5.0° (1.7-9.8°) to 1.0° (0.1-3.6°) for crossed lag screws (p = 0.002). For NC-2, locking plate constructs were better with 0.2° (0.1-0.5°) compared to crossed lag screw osteosynthesis with 0.9° (0.2-1.6°) (p = 0.011). CONCLUSION: Each evaluated fixation technique led to a reduced NC joint rotation. The fixation of any NC joint had no relevant effect on the adjacent NC joints. The results might support surgeons treating NC joint disorders.
BACKGROUND: There have been no biomechanical evaluations of naviculocuneiform (NC) joint fixation. This study compared biomechanically 3 different fixation constructs for NC-1-3 joint fixation. METHODS: The present study compared the three fixation constructs lag screw with locking plate for each NC joint, two crossed lag screws for each NC joint and a separate lag screw for each NC joint with bridging locking plates. NC-1-3 fixation was performed stepwise, and rotation of each joint was evaluated after the application of each lag screw or locking plate and their removal. RESULTS: All examined fixation techniques led to a significant reduced rotation of the NC joints. For NC-1 rotation decreased from 2.8° (Range 1.2-6.6°) to 0.6° (0.2-3.0°) for lag screw and locking plate (p = 0.002) and from 5.0° (1.7-9.8°) to 1.0° (0.1-3.6°) for crossed lag screws (p = 0.002). For NC-2, locking plate constructs were better with 0.2° (0.1-0.5°) compared to crossed lag screw osteosynthesis with 0.9° (0.2-1.6°) (p = 0.011). CONCLUSION: Each evaluated fixation technique led to a reduced NC joint rotation. The fixation of any NC joint had no relevant effect on the adjacent NC joints. The results might support surgeons treating NC joint disorders.
Authors: Sarah Ettinger; Lisa-Christin Hemmersbach; Michael Schwarze; Christina Stukenborg-Colsman; Daiwei Yao; Christian Plaass; Leif Claassen Journal: Foot Ankle Int Date: 2021-08-05 Impact factor: 2.827