Highlights
- •Hinge fracture in distal femoral osteotomy increased abnormal hinge movements.
- •The increased abnormal movements were reduced by the short support plate.
- •The hinge stability was not significantly improved by a hinge support screw.
- •The short support plate can be an option when a hinge fracture occurs.
Abstract
Background
This study aimed to examine the hinge-stabilizing biomechanical effects of hinge support
fixators, applied for lateral hinge fractures sustained following distal femoral osteotomy.
Methods
Medial closing wedge distal femoral osteotomy was performed using a locking plate
on 10 cadaveric limbs. The limbs were divided into two groups: the non-fracture group
and the lateral hinge fracture group. A cyclic axial load of 400 N was applied to
the knee to keep it extended and flexed at 45°. The hinge-stabilizing effects of adding
a screw or a short support plate to the lateral fracture site were examined by measuring
the translation and rotational angles of the anterodistal and posterodistal hinge
positions as well as the surface strains of the medial locking plate.
Findings
Translation and rotation in the fracture group were significantly more pronounced
than in the non-fracture group, at the anterodistal and posterodistal positions. Translations
at both positions were significantly reduced, by adding the support plate, during
both extension and 45-degree flexion in the fracture group. The rotation at the posterodistal
position upon extension and the anterodistal position upon 45-degree flexion was significantly
reduced by the support plate. The surface strain of the medial plate in the fracture
group was significantly reduced by the support plate upon both extension and 45-degree
flexion.
Interpretation
Lateral hinge fractures caused abnormal hinge movements, which were significantly
reduced by the short support plate. A short support plate could be used if a hinge
fracture occurs during distal femoral osteotomy, to improve lateral hinge stability.
Keywords
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Article Info
Publication History
Published online: November 14, 2021
Accepted:
November 9,
2021
Received:
June 1,
2021
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
