TY - JOUR
T1 - Mini-Blade Plate to Obtain Length Across Lateral Malleolus Fractures
T2 - Surgical Technique and Biomechanical Evaluation
AU - Kadar, Assaf
AU - Tommasini, Steven M.
AU - Singla, Amit
AU - Beitler, Brian G.
AU - Moushey, Alexander M.
AU - Baumgaertner, Michael R.
N1 - Publisher Copyright:
© 2021, Indian Orthopaedics Association.
PY - 2022/4
Y1 - 2022/4
N2 - Background: Restoration of fibular length is the main determinant in preventing mal-union and early ankle arthritis in lateral malleolus fractures. A 1/3 tubular plate fashioned into a mini-blade plate can be used to distract the distal fragment and achieve length in a controlled fashion over time. The purpose of this study was to describe the surgical technique and perform a biomechanical comparison of the blade plate to a locking plate. Methods: A 1/3 tubular plate is fashioned into a 135° blade plate. Blades are seated into the lateral malleolus and a distally directed force is applied on the plate to obtain length. A lateral malleolus fracture was created in 20 cadaveric ankles. The distal fragment was fixed with either a blade plate (BP, n = 10) or a locking plate (LP, n = 10). A distally directed force was applied by an Instron machine and fracture distraction, maximal load and construct stiffness were measured and compared. Results: The average maximal load was 262.06 N compared to 255.52 N for the BP and LP groups, respectively. The maximal distraction was 3.57 mm compared to 4.57 mm for the BP and LP groups, respectively. The loading pattern of the blade plate over time differed from that of a locking plate as the blades seat into bone. Conclusion: A 1/3 tubular mini-blade plate demonstrates biomechanical similarities in terms of load and distraction to the more expensive locking plate. We recommend using this technique for fractures with late presentation or with significant shortening. Level of Evidence: Level V—Mechanism-based reasoning.
AB - Background: Restoration of fibular length is the main determinant in preventing mal-union and early ankle arthritis in lateral malleolus fractures. A 1/3 tubular plate fashioned into a mini-blade plate can be used to distract the distal fragment and achieve length in a controlled fashion over time. The purpose of this study was to describe the surgical technique and perform a biomechanical comparison of the blade plate to a locking plate. Methods: A 1/3 tubular plate is fashioned into a 135° blade plate. Blades are seated into the lateral malleolus and a distally directed force is applied on the plate to obtain length. A lateral malleolus fracture was created in 20 cadaveric ankles. The distal fragment was fixed with either a blade plate (BP, n = 10) or a locking plate (LP, n = 10). A distally directed force was applied by an Instron machine and fracture distraction, maximal load and construct stiffness were measured and compared. Results: The average maximal load was 262.06 N compared to 255.52 N for the BP and LP groups, respectively. The maximal distraction was 3.57 mm compared to 4.57 mm for the BP and LP groups, respectively. The loading pattern of the blade plate over time differed from that of a locking plate as the blades seat into bone. Conclusion: A 1/3 tubular mini-blade plate demonstrates biomechanical similarities in terms of load and distraction to the more expensive locking plate. We recommend using this technique for fractures with late presentation or with significant shortening. Level of Evidence: Level V—Mechanism-based reasoning.
KW - Biomechanical
KW - Blade plate
KW - Lateral malleolus
KW - Locking plate
KW - Push–pull
UR - http://www.scopus.com/inward/record.url?scp=85119269130&partnerID=8YFLogxK
U2 - 10.1007/s43465-021-00562-8
DO - 10.1007/s43465-021-00562-8
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C2 - 35342527
AN - SCOPUS:85119269130
SN - 0019-5413
VL - 56
SP - 573
EP - 579
JO - Indian Journal of Orthopaedics
JF - Indian Journal of Orthopaedics
IS - 4
ER -