Biomechanical comparison of a new handy tension band with malleolar screw, bicortical screw and conventional tension band for the fixation of transverse medial malleolar fractures
Tolgahan Kuru1, Fuat Akpınar2, Cengiz Işık3, Recai Özkılıç4, Serdar İpek5, İbrahim Mutlu6, Hasan Kızılay7
1Department of Orthopedics and Traumatology, Onsekiz Mart University Medical Faculty, Çanakkale, Turkey
2Department of Orthopedics and Traumatology, Medeniyet University Medical Faculty, İstanbul, Turkey
3Department of Orthopedics and Traumatology, Abant İzzet Baysal University Medical Faculty, Bolu, Turkey
4Department of Orthopedics and Traumatology, Düzce Atatürk State Hospital, Düzce, Turkey
5Department of Orthopedics and Traumatology, Aksaray University Training and Research Hospital, Aksaray, Turkey
6Department of Biomedical Engineering, Kocaeli University Technology Faculty, Kocaeli, Turkey
7Department of Orthopedics and Traumatology, Gerede State Hospital, Bolu, Turkey
Keywords: Bicortical screw, biomechanics, medial malleolar fracture, tension band.
Objectives: This study aims to compare the biomechanical features of a new handy tension band with the malleolar screw, bicortical screw and conventional tension band for the fixation of transverse medial malleolar fractures. Materials and methods: This study used 20 Kirschner wires, five cerclage wires, six double-hole U pins, six cortical screws, six malleolar screws, three malleolar clamps and one osteotomy set. A total of 24 tibias of two-year-old cows were obtained and stripped from soft tissue. Each tibia was cut with an electric saw at 15 cm proximal to the tibiotalar joint surface and the proximal tibia sections were discarded. A transverse fracture line was created with an osteotome on the medial malleolus. The tibias were separated into four groups with six tibias in each group. The distal tibia medial malleolar transverse fragments were fixed under guidance of fluoroscopy with the malleolar screw, bicortical screw, conventional tension band and the new handy tension band.
Results: In the application of both transverse and axial force, the new handy tension band resisted higher forces in respect of catastrophic damage force being more resistant compared to the bicortical screw, malleolar screw, and conventional tension band. However, in respect of the 2 mm displacement force of the forces applied in the axial and transverse sections, no difference was determined between the handy tension band and the other three implants.
Conclusion: The new handy tension band seems to be more successful when biomechanically compared with the other implants.