Comparison of different internal fixation implants in the treatment of talar neck fractures: A finite element analysis
Xin Fu1
, Hong-Bin Cao2, Nan Li2, Gui-Xin Wang2, Jin-Quan He2
1Department of Orthopedics, Tianjin Hospital, Tianjin, People’s Republic of China
2The First Department of Foot and Ankle Surgery, Tianjin Hospital, Tianjin, People’s Republic of China
Keywords: Cannulated screws, finite element analysis, fixation, plate, talar neck fractures.
Abstract
Objectives: This study aimed to analyze the biomechanics of cannulated screws (CS) with or without a lateral locking plate (LLP) in talar neck fractures through a finite element analysis.
Patients and methods: The computed tomography image of the talus from a healthy volunteer (adult male) was used to reconstruct a three-dimensional talar model. The method for fixing talar neck fractures with CS and an LLP was planned using computer-aided design software. Afterward, the three-dimensional models of comminuted talar neck fractures were used to simulate fixation with anteroposterior parallel dual CS, single CS+LLP, and dual CS+LLP. Finally, finite element analysis was carried out to compare the outcomes of dual CS+LLP to those of single CS+LLP and to those of using dual CS alone. The displacement and von Mises stress values of the three groups with different internal fixation were analyzed.
Results: For a simple talar neck fracture, the lowest amount of displacement was obtained with CS+LLP (0.407 mm), while dual CS (0.459 mm) showed the highest amount of total displacement; the lowest amount of peak stresses was obtained with CS+LLP (5.38 MPa), while dual CS (8.749 MPa) showed the highest amount of total peak stresses. For a comminuted talar neck fracture, the lowest amount of displacement was obtained with CS+LLP (0.398 mm), while dual CS (0.408 mm) showed the highest amount of total displacement; the lowest amount of peak stresses was obtained with CS+LLP (129.9 MPa), while dual CS (205.9 MPa) showed the highest amount of peak stresses.
Conclusion: Compared to the other two groups, the dual CS+LLP group had better biomechanics properties in the displacement and stress peak of the talus and implant. Thus, the use of dual CS+LLP fixation is recommended for the surgical treatment of comminuted talar neck fractures.
Citation: Fu X, Cao HB, Li N, Wang GX, He JQ. Comparison of different internal fixation implants in the treatment of talar neck fractures: A finite element analysis. Jt Dis Relat Surg 2024;35(1):iix. doi: 10.52312/jdrs.2023.1280.