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Title: Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures
Authors: Ni, M
Wong, DWC 
Mei, J
Niu, W
Zhang, M 
Issue Date: Sep-2016
Source: Science China. Life sciences, Sept. 2016, v. 59, no. 9, p. 958-964
Abstract: The locking plate and percutaneous crossing metallic screws and crossing absorbable screws have been used clinically to treat intra-articular calcaneal fractures, but little is known about the biomechanical differences between them. This study compared the biomechanical stability of calcaneal fractures fixed using a locking plate and crossing screws. Three-dimensional finite-element models of intact and fractured calcanei were developed based on the CT images of a cadaveric sample. Surgeries were simulated on models of Sanders type III calcaneal fractures to produce accurate postoperative models fixed by the three implants. A vertical force was applied to the superior surface of the subtalar joint to simulate the stance phase of a walking gait. This model was validated by an in vitro experiment using the same calcaneal sample. The intact calcaneus showed greater stiffness than the fixation models. Of the three fixations, the locking plate produced the greatest stiffness and the highest von Mises stress peak. The micromotion of the fracture fixated with the locking plate was similar to that of the fracture fixated with the metallic screws but smaller than that fixated with the absorbable screws. Fixation with both plate and crossing screws can be used to treat intra-articular calcaneal fractures. In general, fixation with crossing metallic screws is preferable because it provides sufficient stability with less stress shielding.
Keywords: Absorbable screw
Biomechanics
Calcaneal fracture
Finite-element analysis
In vitro experiment
Plate fixation
Publisher: Science China Press, co-published with Springer
Journal: Science China. Life sciences 
ISSN: 1674-7305
EISSN: 1869-1889
DOI: 10.1007/s11427-016-0010-9
Rights: © 2016, The Author(s)
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
The following publication Ni, M., Wong, D. W. C., Mei, J., Niu, W., & Zhang, M. (2016). Biomechanical comparison of locking plate and crossing metallic and absorbable screws fixations for intra-articular calcaneal fractures. Science China Life Sciences, 59(9), 958-964 is available at https://doi.org/10.1007/s11427-016-0010-9
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