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-
1.
Ramsey PL, Hamilton W: Changes in tibiotalar area of contact caused by lateral talar shift. J Bone Joint Surg Am 58: 356, 1976.
-
2.
King CM, Cobb M, Collman DR. et al: Bicortical fixation of medial malleolar fractures: a review of 23 cases at risk for complicated bone healing. J Foot Ankle Surg 51: 39, 2012.
-
3.
Muller GM: Fractures of internal malleoulus. BMJ 2: 320, 1945.
-
4.
Femino JE, Gruber BF, Karunakar MA: Safe zone for the placement of medial malleolar screws. J Bone Joint Surg Am 89: 133, 2007.
-
5.
Georgiadis GM, White DB: Modified tension band wiring of medial malleolar ankle fractures. Foot Ankle Int 16: 64, 1995.
-
6.
Johnson BA, Fallat LM: Comparison of tension band wire and cancellous bone screw fixation for medial malleolar fractures. J Foot Ankle Surg 36: 284, 1997.
-
7.
Kanakis TE, Papadakis E, Orfanos A, et al: Figure eight tension band in the treatment of fractures and pseudarthroses of the medial malleolus. Injury 21: 393, 1990.
-
8.
Weber BG, Colton C: “Malleolar Fractures,” in Manual of Internal Fixation: Techniques Recommended by the AO-ASIF Group, 3rd Ed, ed by ME Mueller, M Allgower, R Schneider, et al, p 595, Springer-Verlag, New York, 1991.
-
9.
Perren SM, Frigg R, Hehli M, et al: “Lag Screw,” in AO Principles of Fracture Management, ed by CL Colton, A Fernandez Dell’Oca, U Holz, p 157, Thieme, Stuttgart, Germany, 2000.
-
10.
Bucholz RW, Henry S, Henley MB: Fixation with bioabsorbable screws for the treatment of fractures of the ankle. J Bone Joint Surg Am 76: 319, 1994.
-
11.
Fowler TT, Pugh KJ, Litsky AS, et al: Medial malleolar fractures: a biomechanical study of fixation techniques. Orthopedics 34: e349, 2011.
-
12.
Uygur E, Poyanli O, Mutlu İ, et al: Medial malleolus fractures: a biomechanical comparison of tension band wiring fixation methods. Orthop Traumatol Surg Res 104: 1259, 2018.
-
13.
Dumigan RM, Bronson DG, Early JS: Analysis of fixation methods for vertical shear fractures of the medial malleolus. J Orthop Trauma 20: 687, 2006.
-
14.
White TO, Bugler KE: “Ankle Fractures,” in Rockwood and Green’s Fractures in Adults, 8th Ed, ed by CM Court-Brown, JD Heckman, MM Mc Queen, et al, p 2542, Wolters Kluwer, New York, 2015.
-
15.
Wild M, Fischer K, Hilsenbeck F, et al: Treating patella fractures with a fixed-angle patella plate: a prospective observational study. Injury 47: 1737, 2016.
-
16.
Jacobsen S, Lichtenberg MHD, Jensen CM, et al: Removal of internal fixation: the effect on patients’ complaints: a study of 66 cases of removal of internal fixation after malleolar fractures. Foot Ankle Int 15: 170, 1994.
-
17.
DeMill SL, Bussewitz BW, Philbin TM: Injury to the posterior tibial tendon after open reduction internal fixation of the medial malleolus. Foot Ankle Specialist 8: 360, 2015.
-
18.
Hahn DM, Colton CL: “Malleolar Fractures,” in AO Principles of Fracture Management, edited by TP Rüedi, WM Murphy, CL Colton, et al, p 575,Thieme, Stuttgart, Germany, 2000.
-
19.
Shayaa S: Comparative study of operative fixation of fracture of medial malleolus by malleolar screw versus tension band wiring. Int J Surg 4: 157, 2020.
-
20.
Georgiadis GM, White DB: Modified tension band wiring of medial malleolar ankle fractures. Foot Ankle Int 16: 64, 1995.
-
21.
Clyde J, Kosmopoulos V, Carpenter B: A biomechanical investigation of a knotless tension band in medial malleolar fracture models in composite Sawbones®. J Foot Ankle Surg 52: 192, 2013.
-
22.
Ali M, Kuiper J, John J: Biomechanical analysis of tension band wiring (TBW) of transverse fractures of patella. Chinese J Traumatol 19: 255, 2016.
-
23.
Marsh JL, Slongo TF, Agel J, et al: Fracture and dislocation classification compendium-2007: Orthopaedic Trauma Association Classification, Database and Outcomes Committee. J Orthop Trauma 21(suppl): S1, 2007.
-
24.
Loveday DT, Arthur A, Tytherleigh-Strong GM: Technical tip: fixation of medial malleolar fractures using a suture anchor. Foot Ankle Int 30: 68, 2009.
Biomechanical Comparison of Single- and Double-Twist Tension Band, Cancellous Screw, and Single-Screw Tension Band Models in Medial Malleolus Fractures
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Background: Models using a double-twist tension band, two partially threaded cancellous screws, a single-twist tension band, and a single-screw tension band were biomechanically compared for fixation of medial malleolus fractures.
Methods: All 72 composite cortical tibial bones used in the study were osteotomy suitable for medial malleolus fracture. They were divided into four groups: double-twist tension band (group 1), two partially threaded cancellous screws (group 2), single-twist tension band (group 3), and single-screw tension band (group 4), with 18 composite tibial bones in each group. Bones in each group were divided into three subgroups and subjected to biomechanical tests by applying force as tension, transverse, and axial loading.
Results: In the tension and transverse loading tests, the highest mean stiffness was in groups 1 and 4. Group 4 had statistically significantly higher stiffness values than groups 2 and 3. All of the other groups had statistically significantly higher stiffness values than group 2. A statistically significant difference was found comparing group 4 (with the highest value in the axial loading test) with the other groups. No significant difference was found between groups 1 and 3 in any of the biomechanical tests.
Conclusions: Tension band method did not make a difference biomechanically when applied as a double or single twist. Single-screw tension band was found to be the most stable fixation method in tension, transverse, and axial loading tests. We think that the single-screw tension band method is a stable and suitable fixation method and should find more place in current surgical practices.
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