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Published on: March 22, 2018
Biomechanical analysis of endobutton versus screw fixation after Lisfranc ligament complex sectioning
Daniel Marsland1, Stephen M Belkoff, Matthew C Solan
1International Center for Orthopaedic Advancement, The Johns Hopkins University, Baltimore, MD, USA.
Background:
Our goal was to compare diastasis after endobutton and screw fixation after Lisfranc ligament complex sectioning.
Methods:
Twenty-four (12 pairs) fresh-frozen cadaveric feet were assigned to endobutton or screw fixation and loaded to 343N. Displacement (first-second metatarsal bases) was measured in intact feet and after ligament sectioning (Lisfranc, medial-intermediate cuneiform ligaments), fixation, and 10,000 cycles.
Results:
The mean change in diastasis for endobutton and screw fixation under initial loading was 1.0mm (95% CI, 0.2-1.9mm) and 0.0mm (95% CI, -0.4 to 0.4mm), respectively (p=0.017). After cyclic loading, diastasis decreased (mean, -0.7mm, 95% CI, -1.2 to -0.1mm) in the endobutton group but was unchanged in the screw group (p=0.035).
Conclusions:
Diastasis after endobutton fixation was significantly greater than after screw fixation under initial loading but did not increase further after cyclic loading.
