Biomechanical Comparison of Hook Plate vs Headless Compression Screw Fixation of Large Fifth Metatarsal Base Avulsion Fractures.
Citation: Foot & Ankle International. 42(1):89-95, 2021 Jan.PMID: 32981339Institution: MedStar Union Memorial HospitalDepartment: Curtis National Hand Center | Orthopaedic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Fractures, Avulsion/su [Surgery] | *Fractures, Bone/su [Surgery] | *Metatarsal Bones/su [Surgery] | Biomechanical Phenomena | Bone Plates | Bone Screws | Epiphyses/ph [Physiology] | Humans | PressureYear: 2021Local holdings: Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006ISSN:- 1071-1007
- Smyth, Niall A:
- https://orcid.org/0000-0002-4527-9637
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 32981339 | Available | 32981339 |
Available online from MWHC library: 1999 - present, Available in print through MWHC library: 1999 - 2006
BACKGROUND: Debate exists on the optimum fixation construct for large avulsion fractures of the fifth metatarsal base. We compared the biomechanical strength of 2 headless compression screws vs a hook plate for fixation of these fractures.
CLINICAL RELEVANCE: Whether using hook plates or headless compression screws, surgeons should consider protecting patient weight-bearing after fixation of fifth metatarsal base large avulsion fracture until bony union has occurred.
CONCLUSION: A hook plate construct was biomechanically superior to a headless compression screw construct for fixation of large avulsion fractures of the fifth metatarsal base.
METHODS: Large avulsion fractures were simulated on 10 matched pairs of fresh-frozen cadaveric specimens. Specimens were assigned to receive two 2.5-mm headless compression screws or an anatomic fifth metatarsal hook plate, then cyclically loaded through the plantar fascia and metatarsal base. Specimens underwent 100 cycles at 50%, 75%, and 100% physiological load for a total of 300 cycles.
RESULTS: The hook plate group demonstrated a significantly higher number of cycles to failure compared with the screw group (270.7 +/- 66.0 [range 100-300] cycles vs 178.6 +/- 95.7 [range 24-300] cycles, respectively; P = .039). Seven of 10 hook plate specimens remained intact at the maximum 300 cycles compared with 2 of 10 screw specimens. Nine of 10 plate specimens survived at least 1 cycle at 100% physiologic load compared with 5 of 10 screw specimens.
English