Locking vs. non-locking plate fixation in comminuted talar neck fractures: a biomechanical study using cadaveric...

Area of Science:

• Orthopedic surgery
• Biomechanics
• Traumatology

Background:

• Talar neck fractures are severe injuries requiring prompt reduction and fixation to prevent complications like avascular necrosis.
• Malunion can significantly disrupt subtalar joint function and load transmission.
• Dual plating techniques are evolving, with locked plating showing potential benefits in specific fracture types.

Purpose of the Study:

• To compare the biomechanical strength of locking versus non-locking plate fixation in comminuted talar neck fractures.

Main Methods:

• Seven pairs of cadaveric tali underwent standardized comminuted talar neck fracture creation.
• Specimens were randomly assigned to either locking or non-locking plate fixation.
• Constructs were tested to failure under axial load using a motorized device.

Main Results:

• No statistically significant differences were observed between locking and non-locking constructs in peak load to failure, deformation, work to failure, or stiffness.
• The mean peak load to failure did not surpass the theoretical maximum weight-bearing forces.

Conclusions:

• Both locking and non-locking plate constructs demonstrate comparable strength for talar neck fracture fixation.
• Clinicians should exercise caution regarding early mobilization in patients with fixed talar neck fractures, regardless of fixation type.