Biomechanical Comparison of Fibertape Device Repair Techniques of Ligamentous Lisfranc Injury in a Cadaveric Model

Biomechanical Comparison of Fiber Tape Device Versus Transarticular Screws for Ligamentous Lisfranc Injury in a Cadaveric Model

“…Eight matched fresh-frozen pairs of human cadaveric transtibial specimens (midtibia/fibula to toes; 16 specimens total) without preexisting foot deformity were obtained (Anatomy Gifts Registry) and prepared according to previous work. 7 , 24 The cohorts consisted of 5 male and 3 female donors with an average age of 50 years (range, 25-68), an average height of 69 inches (range, 64-71), and an average weight of 158 lb (range, 115-260). All specimens were thawed overnight.…”

“…Careful dissection involved the removal of the dorsal subcutaneous tissue while preserving the capsular attachments of the midfoot and maintaining the tie rod mechanism of the arch, which was performed according to previously published work. 21 , 24 , 38 Miniature screws (2-mm head, 4-mm length), used as coordinate markers for diastasis measurements, were inserted into the 2MT, MC, and IC, which were predrilled with a Kirschner wire for pilot holes ( Figure 1 ). Two screws were inserted within each bone and placed as close to the joints as possible without disrupting the path of operative repair to provide an accurate measurement of diastasis at each joint ( Figure 1B ).…”

“…The purely ligamentous Lisfranc injury model was created using radiographic guidance in an apparatus that involved weighted plates as previously described. 24 Specimens were placed under a static load equal to 50% of their donor body weight (BW) to simulate weightbearing radiographs, which are the most common and preferred method of identifying Lisfranc injuries ( Figure 2 , A - D ). 39 The dorsal, interosseous, and plantar Lisfranc ligaments were carefully sectioned using a 10-blade scalpel with no further disruption visualized at the more proximal intercuneiform joint as performed in previous work ( Figure 2 , A and C ).…”

“…39 The dorsal, interosseous, and plantar Lisfranc ligaments were carefully sectioned using a 10-blade scalpel with no further disruption visualized at the more proximal intercuneiform joint as performed in previous work ( Figure 2 , A and C ). 24 Once sectioned, the joint space was widened using a narrow osteotome while avoiding injury to any other tarsal ligamentous structure ( Figure 2 , B and D ). A successful injury model was defined as diastasis ≥2 mm observed at the Lisfranc articulation.…”

“…12 Cyclic loading, using 100-N stepwise increases in ground-reaction force, was performed similarly to previous work. 24 Loading was performed at 100 cycles at 1 Hz and a peak magnitude of 50% BW 1 100-N (compressive) ground-reaction force, followed by 100 cycles at 50% BW 1 200 N, with the force increasing by 100 N every 100 cycles. For all cycles, the ''valley'' magnitude of load was 50% BW.…”