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A Biomechanical Study of Calcaneal Tuberosity Avulsion Fracture: A Comparison Between Three-Screw Versus Two-Screw
Kwong-Lee Wan1, Sugesh Raghavan2, YeokPin Chua3
1Department of Orthopaedics and Traumatology, Raja Permaisuri Bainun Hospital, Ipoh, MYS.
Cureus
|April 26, 2024
Summary
A three-screw fixation method for calcaneal tuberosity avulsion fractures demonstrated superior pull-out strength compared to two-screw fixation. This enhanced fixation may reduce soft tissue compromise during surgical repair.
Area of Science:
- Orthopedic surgery
- Biomechanics
- Trauma surgery
Background:
- Calcaneal tuberosity avulsion fractures risk soft tissue compromise, requiring prompt fixation.
- Traditional two-screw fixation has reported failure rates.
- Novel fixation techniques are needed to improve outcomes.
Purpose of the Study:
- To compare the biomechanical strength of two-screw (2S) versus three-screw (3S) fixation for calcaneal tuberosity avulsion fractures.
- To evaluate the tensile load and stiffness of different screw configurations.
Main Methods:
- Synthetic calcaneum models were used for testing.
- An Instron machine measured maximum tensile load and stiffness.
- Two fixation methods were compared: 2S and 3S (with an additional posterior-to-anterior screw).
Main Results:
- The 3S fixation exhibited a statistically significant higher mean maximum tensile load (455.8 N) than 2S fixation (341.0 N).
- Stiffness differences between 3S (29.2 N/mm) and 2S (29.7 N/mm) were not statistically significant.
- The third screw significantly increased pull-out strength.
Conclusions:
- Three-screw fixation offers enhanced pull-out strength for calcaneal tuberosity avulsion fractures compared to two-screw fixation.
- Percutaneous insertion of the third screw can minimize soft tissue damage.
- This technique presents a promising alternative for improved fracture fixation and reduced complications.
Keywords:
calcaneal achilles tendon pullcalcaneal avulsion fracturecalcaneal beak-type fracturecalcaneal tongue-type fracturecalcaneal tuberosity fracturecalcaneum screw fixationMore Related Videos
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