Biomechanical Comparison of Hook Plate vs Headless Compression Screw Fixation of Large Fifth Metatarsal Base Avulsion Fractures.
- 2021
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
1071-1007
10.1177/1071100720953083 [doi]
*Fractures, Avulsion/su [Surgery] *Fractures, Bone/su [Surgery] *Metatarsal Bones/su [Surgery] Biomechanical Phenomena Bone Plates Bone Screws Epiphyses/ph [Physiology] Humans Pressure