Comparative experimental study of the biomechanical properties of anterior ankle fusion anatomic plate and double titanium reconstruction plate in ankle fusion
Lin Xuping1, Liu Qingjun1, Liu Sijie2, Ding Zhenqi1, Lin Bin1, Lin Weihuang3, Xie Weina4
1Department of Orthopedic, the 909th Hospital of Joint Service Support Force of PLA (the Affiliated Dongnan Hospital of Xiamen University), Zhangzhou 363000, China; 2Department of Radiology, the 909th Hospital of Joint Service Support Force of PLA (the Affiliated Dongnan Hospital of Xiamen University), Zhangzhou 363000, China; 3Department of Orthopedic Surgery, Xiamen Haicang Hospital, Xiamen 361000, China; 4Department of Anesthesiology, the 909 th Hospital of Joint Service Support Force of PLA (the Affiliated Dongnan Hospital of Xiamen University), Zhangzhou 363000, China
Abstract：Objective Biomechanical comparative analysis was carried out between anterior ankle fusion anatomic plate and double titanium reconstruction plate for ankle fusion to provide biomechanical basis for complex ankle joint fusion. Methods Sixteen fresh adult calf-ankle specimens were selected, including eight males and eight females aged 36-60 years with a mean age of 45 years. The specimens were randomly divided into groups A and B by numerical table method with eight specimens in each group. The ankle surfaces of the two groups were destroyed to prepare traumatic ankle specimens. Group A used the self-developed ankle anterior fusion anatomical plate for anterior ankle fusion fixation, whereas group B used the traditional double titanium reconstruction plate for anterior ankle fusion fixation. Postoperatively, the torsional resistance of the two groups of specimens was tested at the torques of 1.0, 2.0, 3.0, 4.0, and 5.0 N·m. The axial compression properties of the specimens were tested in the neutral and dorsal extension positions at the pressures of 100, 200, 300, 400, 500, 600, and 700 N. The anti-fatigue performance of the specimens was tested at 700 N pressure for 1 000 and 30 000 times. X-ray fluoroscopy was performed, and the suture of the specimen was removed to observe whether the ankle joint fixation plate was deformed and whether the screw was loosened or broken. Results At 4 and 5 N·m torques, the torsion angles in group A (3.39°±0.33°, 4.20°±0.20°) were less than those in group B (3.85°±0.42°, 4.64°±0.38°), with statistically significant differences (t=2.44, 2.87; P=0.028, 0.012). The torsional stiffness of group A was (1.69±0.27) N·m/° at 5 N·m torque, which was higher than that ([1.45±0.39] N·m/°) of group B, but the difference was not statistically significant (t=1.67, P=0.118). The axial compression displacements between the two groups in neutral and dorsal extension positions had no significant differences at 100, 200, 300, and 400 N pressure (all P values>0.05). The axial compression displacements in neutral and dorsal extension positions in group A were smaller than those in group B at 500, 600, and 700 N pressure, and the differences were statistically significant (all P values<0.05). At 700 N pressure, the axial compression stiffness of group A (244.38±26.60) N/mm was greater than that of group B (207.88±18.95) N/mm, and the difference was statistically significant (t=3.16, P=0.007). For the intragroup comparison of fatigue resistance, the differences in axial compression displacement between the two groups were not statistically significant at 1000 and 30000 compressions (all P value>0.05). For the intergroup comparison, the axial compression displacement of group A was smaller than that of group B at 1 000 and 30 000 compressions, and the differences were statistically significant (all P value<0.05). In group A, no screw loosening, fracture, and plate deformation were found, whereas in group B, plate bending deformation occurred in one case and locking screw loosening occurred in two cases after 30 000 times of compression. Conclusion The biomechanical properties of the ankle anterior fusion anatomical plate are remarkably better than those of the double titanium reconstruction plate, which provides biomechanical data support for the clinical application of the anterior ankle fusion anatomical plate.
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Lin Xuping, Liu Qingjun, Liu Sijie, Ding Zhenqi, Lin Bin, Lin Weihuang, Xie Weina. Comparative experimental study of the biomechanical properties of anterior ankle fusion anatomic plate and double titanium reconstruction plate in ankle fusion. Chinese Journal of Anatomy and Clinics, 2022, 27(12): 843-849.
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2022, Vol. 27 
