Basic Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Aug 18, 2021; 12(8): 548-554
Published online Aug 18, 2021. doi: 10.5312/wjo.v12.i8.548
Fibula pro-tibia vs standard locking plate fixation in an ankle fracture saw bone model
Tosan Okoro, Kar Hao Teoh, Hiro Tanaka
Tosan Okoro, Department of Arthroplasty, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry SY10 7AG, United Kingdom
Kar Hao Teoh, Department of Orthopaedic Surgery, Princess Alexandra Hospital NHS Trust, Harlow CM20 1QX, United Kingdom
Hiro Tanaka, Department of Orthopaedics, Royal Gwent Hospital, Newport NP20 2UB, United Kingdom
Author contributions: Okoro T contributed study design, performance of biomechanical testing, analysis of results, drafting and proof reading of manuscript; Teoh KH contributed study design, analysis of results, drafting and proof-reading of manuscript; Tanaka H contributed study design, supervision of study, analysis of results, drafting and proof reading of manuscript.
Supported by Research Grant Provided by AOUK.
Institutional review board statement: This was a biomechanical study and did not involve human and the use of animals.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tosan Okoro, BSc, FRCS, MBChB, PhD, Doctor, Surgeon, Department of Arthroplasty, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Gobowen, Oswestry SY10 7AG, United Kingdom. tosanwumi@hotmail.com
Received: February 9, 2021
Peer-review started: February 9, 2021
First decision: June 25, 2021
Revised: July 2, 2021
Accepted: August 2, 2021
Article in press: August 2, 2021
Published online: August 18, 2021
ARTICLE HIGHLIGHTS
Research background

The lateral malleolus is key to the anatomical reduction of displaced bi-malleolar fractures, and restoring its structural integrity restores the integrity of the ankle. Various fixation techniques have been utilized in osteoporotic bone to ensure lateral malleolar integrity.

Research motivation

Biomechanical assessment of whether there is an increased strength to failure with a fibula pro-tibia construct when compared with standard locking plate fixation for ankle fractures in an ankle fracture saw bone model.

Research objectives

To compare a fibula pro-tibia construct to standard locking plate fixation in a saw bone model using biomechanical parameters.

Research methods

After simulation of supination/external rotation injuries in a series of n = 10 sawbones, n = 5 were fixed with the fibula pro-tibia construct and n = 5 were fixed with the standard locking plate. Biomechanical analysis was performed to assess torque (N/m) at 30 degrees external rotation, maximum failure torque (N/m) and external rotation angle (°) at failure. Students t test was used for comparison of both groups.

Research results

The fibula pro-tibia construct was biomechanically superior to the standard locking plate in torque at 30 degrees external rotation, and maximum failure torque. There was no statistically significant difference in the external rotation angle at failure.

Research conclusions

There is merit to considering the use of the fibula pro-tibia construct in fixation of bimalleolar ankle fractures in view of its biomechanical superiority over standard locking plates.

Research perspectives

Future research should evaluate the clinical significance of these findings.