Biomechanical Comparison of Intramedullary Screw Versus Low-Profile Plate Fixation of a Jones Fracture

Huh, Jeannie; Glisson, Richard R.; Matsumoto, Takumi; Easley, Mark E.

doi:10.1177/1071100715619678

Cited by 42 publications

(35 citation statements)

References 19 publications

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“…Several studies evaluated different fixation methods for surgical Jones fracture treatment in various biomechanical test setups. 2,5,8,12,[14][15][16][17][25][26][27]31,[38][39][40][41] Recent attention has been focused on Jones fracture-specific implants such as specifically designed screws and plates. 2,4,16,20,31,32,40,41 Latest biomechanical studies revealed contradictory results comparing Jones fracturespecific screw to plate fixation.…”

Section: Discussionmentioning

confidence: 99%

“…2,5,8,12,[14][15][16][17][25][26][27]31,[38][39][40][41] Recent attention has been focused on Jones fracture-specific implants such as specifically designed screws and plates. 2,4,16,20,31,32,40,41 Latest biomechanical studies revealed contradictory results comparing Jones fracturespecific screw to plate fixation. 8,10,14,16,17,[23][24][25][26][27][28]40,41 The comparison of two intramedullary screw constructs was technically more appealing to us because the clinical use of percutaneous screw placement is generally accepted as gold standard treatment.…”

Section: Discussionmentioning

confidence: 99%

“…2,4,16,20,31,32,40,41 Latest biomechanical studies revealed contradictory results comparing Jones fracturespecific screw to plate fixation. 8,10,14,16,17,[23][24][25][26][27][28]40,41 The comparison of two intramedullary screw constructs was technically more appealing to us because the clinical use of percutaneous screw placement is generally accepted as gold standard treatment. With our biomechanical test setup we tried to simulate an early post-operative partial weight-bearing regimen by cyclic plantar to dorsal loading.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Two Types of Intramedullary Jones Fracture Fixation in a Cyclic and Ultimate Load Model

Willegger

Benca

Hirtler

et al. 2019

Journal Orthopaedic Research

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Implant choice is a matter of concern in athletes and active patients who sustain a Jones fracture because they are prone to failure including non‐union, screw failure, and refracture. The aim of this study was to compare the biomechanical behavior of a Jones fracture‐specific screw (JFXS) with a cannulated headless compression screw (HCS) in a simulated partial weight‐bearing and ultimate load Jones fracture fixation model. Ten matched pairs of human anatomical specimens underwent Jones fracture creation and consecutive intramedullary stabilization with a solid JFXS or a cannulated HCS. The bone mineral density was assessed prior to testing. Cyclic plantar to dorsal loading was applied for 1000 cycles, followed by load to failure testing. Angulation was measured by an opto‐electronic motion capture system and mode of failure classification was determined by video analysis. Paired analysis showed no statistically significant difference between both screw constructs. Ultimate load reached 236.9 ± 107.8 N in the JFXS group compared with 210.8 ± 150.7 N in the HCS group (p = 0.429). The bone mineral density correlated positive with the pooled ultimate load (R = 0.580, p = 0.007) for all constructs and negatively with angulation (R = −0.680, p = 0.002) throughout cyclic loading. Solid fracture‐specific and cannulated headless compression screws provide equal ultimate loads and stiffness for Jones fracture fixation. A low bone mineral density significantly impairs the construct stability and the ultimate load of both intramedullary screw constructs. © 2019 The Authors. Journal of Orthopaedic Research ® published by Wiley Periodicals, Inc. on behalf of Orthopaedic Research Society J Orthop Res 38:911‐917, 2020

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluation of Two Types of Intramedullary Jones Fracture Fixation in a Cyclic and Ultimate Load Model

Willegger

Benca

Hirtler

et al. 2019

Journal Orthopaedic Research

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“…Using simulated cadaveric Jones fractures, Huh et al compared intramedullary screws with the low profile plate. Biomechanically, the intramedullary screw resulted in greater bending stiffness, less fracture site angulation, and greater initial torsional stiffness compared to the hook plate [29].…”

Section: Discussionmentioning

confidence: 97%

Zone II and III fifth metatarsal fractures in athletes

Anderson

2017

Curr Rev Musculoskelet Med

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“…The main finding of this study is the efficacity of the fixation using a LCP distal ulna hook plate for a novel approach. There were only 4 studies studied the plate in the treatment of FMBFs [ 13 , 15 – 17 ]. Three studies had evaluated the results of surgical treatment of zones I and II FMBFs using a mini-hook plate [ 13 , 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Locking compression plate distal ulna hook plate fixation versus intramedullary screw fixation for displaced avulsion fifth Metatarsal Base fractures: a comparative retrospective cohort study

Xie

Guo

Zhang

et al. 2017

BMC Musculoskelet Disord

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Background: Intramedullary screw (IMS) fixation was wildly used in fifth metatarsal base fractures (FMBFs) and the results were satisfactory. However, in the comminuted osteoporosis or small displaced avulsion FMBFs, anatomical reduction and stable fixation could not be achieved with IMS. The Locking Compression Plate (LCP) distal ulna hook plate fixation was a novel alternative fixation method. The aim of this retrospective cohort study was to determine if LCP distal ulna hook plate fixation resulted in improved outcomes compared to the traditional IMS fixation in displaced avulsion FMBFs. Methods: Of 43 patients with displaced avulsion FMBFs, 18 patients were treated with LCP distal ulna hook plate fixation and 25 were treated with IMS fixation. The patients were evaluated clinically and radiographically and followed up to 12 months. The surgery time, time for hospital stay, time for weight-bearing, time for bony union, time for return to daily life, pain relief, functional outcome and complications after treatment with LCP distal ulna hook plate fixation or IMS fixation were compared. The functional outcome was assessed by the AOFAS (American Orthopedic Foot and Ankle Society) mid-foot score at 3, 6, 9, and 12 months after surgery. Meanwhile, pain scores were obtained at 3, 6, 9, and 12 months after surgery. Results: The two cohorts had similar baseline characteristics. Surgery time was less in LCP distal ulna hook plate fixation cohort compare to IMS fixation cohort (p < 0.0001). Time for partial weight-bearing (p < 0.0001) and full weight-bearing (p < 0.0001) also demonstrated significant improvements in patients with LCP distal ulna hook plate fixation compared to IMS fixation. Patients in the LCP distal ulna hook plate fixation cohort had significantly increased AOFAS at 9 months (p < 0.0001) and 12 months (p < 0.0001) after surgery compared to the IMS fixation cohort. Conclusion: In this retrospective cohort study, LCP distal ulna hook plate fixation as an alternative fixation method was better therapy for the displaced avulsion FMBFs compared to IMS fixation. LCP distal ulna hook plate fixation had a short surgery time and improved functional performance.

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Biomechanical Comparison of Intramedullary Screw Versus Low-Profile Plate Fixation of a Jones Fracture

Cited by 42 publications

References 19 publications

Evaluation of Two Types of Intramedullary Jones Fracture Fixation in a Cyclic and Ultimate Load Model

Evaluation of Two Types of Intramedullary Jones Fracture Fixation in a Cyclic and Ultimate Load Model

Zone II and III fifth metatarsal fractures in athletes

Locking compression plate distal ulna hook plate fixation versus intramedullary screw fixation for displaced avulsion fifth Metatarsal Base fractures: a comparative retrospective cohort study

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