Locking vs. non-locking plate fixation in comminuted talar neck fractures: a biomechanical study using cadaveric specimens

Luke Maxwell; Tobia Nava; Alan Norrish; Tamas Kobezda; Marc Pizzimenti; Cecilia Brassett; Chandra Pasapula

doi:10.1016/j.foot.2024.102084

$Locking vs. non-locking plate fixation in comminuted talar neck fractures: a biomechanical study using cadaveric specimens$

Journal article

Open access

Peer reviewed

Locking vs. non-locking plate fixation in comminuted talar neck fractures: a biomechanical study using cadaveric specimens

Luke Maxwell, Tobia Nava, Alan Norrish, Tamas Kobezda, Marc Pizzimenti, Cecilia Brassett and Chandra Pasapula

Foot (Edinburgh, Scotland), Vol.59, 102084

06/2024

DOI: 10.1016/j.foot.2024.102084

PMID: 38513373

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Abstract

Talar neck fractures are rare but potentially devastating injuries, with early reduction and rigid fixation essential to facilitate union and prevent avascular necrosis. Even small degrees of malunion will alter load transmission and subtalar joint kinematics. Changes in fixation techniques have led to dual plating strategies. While locked plating has perceived advantages in porotic bone and comminution, its biomechanical benefits in talar neck fractures have not been shown. To compare the strength of locking vs. non-locking plate fixation in comminuted talar neck fractures. Seven pairs of cadaveric tali were randomised to locking or non-locking plate fixation. A standardised model of talar neck fracture with medial comminution was created, and fixation performed. The fixed specimens were mounted onto a motorised testing device, and an axial load applied. Peak load to failure, deformation at failure, work done to achieve failure, and stiffness of the constructs were measured. No statistically significant difference was found between locking and non-locking constructs for all parameters. Both constructs provide similar strength to failure in talar neck fracture fixations. Mean peak load to failure did not exceed the theoretical maximum forces generated of 1.1 kN when weight-bearing. We would advocate caution with early mobilisation in both fixations. •Locking and non-locking plates for talar neck fractures are biomechanically similar.•Fixation strength was directly compared using uniaxial loading on isolated tali.•Mechanisms of failure varied between the two fixation methods.

Biomechanics

Cadaveric study

Locking plate

Plate fixation

Talus fractures

Details

Title: Subtitle: Locking vs. non-locking plate fixation in comminuted talar neck fractures: a biomechanical study using cadaveric specimens
Creators: Luke Maxwell - University of Cambridge
Tobia Nava - University of Cambridge
Alan Norrish - Queen Elizabeth Hospital King's Lynn NHS Foundation Trust
Tamas Kobezda - Queen Elizabeth Hospital King's Lynn NHS Foundation Trust
Marc Pizzimenti - University of Iowa
Cecilia Brassett - University of Cambridge
Chandra Pasapula - Queen Elizabeth Hospital King's Lynn NHS Foundation Trust
Resource Type: Journal article
Publication Details: Foot (Edinburgh, Scotland), Vol.59, 102084
Publisher: Elsevier Ltd
DOI: 10.1016/j.foot.2024.102084
PMID: 38513373
ISSN: 0958-2592
eISSN: 1532-2963
Grant note: DOI: 10.13039/501100000735, name: University of Cambridge
Language: English
Date published: 06/2024
Academic Unit: Anatomy and Cell Biology; Health and Human Physiology
Record Identifier: 9984573830402771

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