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Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion.

Publication ,  Journal Article
Dayton, P; Hatch, DJ; Santrock, RD; Smith, B
Published in: J Foot Ankle Surg
2018

Although plating on the plantar, tension-side of the metatarsocuneiform joint provides an inherent biomechanical advantage for Lapidus arthrodesis, it has not been widely adopted owing to the morbidity associated with plantar application. To overcome these limitations, a modification to 90-90 locked biplanar plating was developed to provide the biomechanical advantages of multiplanar fixation and tension-side fixation, allowing application through a conventional incision. We tested the hypothesis that biplanar plating with tension-side fixation (low-profile straight dorsal plate and anatomic medial-plantar plate) would demonstrate improved mechanical stability compared with a previously tested 90-90 biplanar construct (small straight plate dorsally and medially) under cyclic loading. Both constructs were tested in static load to failure (3 pairs) and cyclic loading (10 pairs) with plantar cantilever bending using surrogate anatomic bone models. With static ultimate failure, the biplanar plate construct with tension-side fixation failed at a significantly greater failure load than did the straight biplanar plate construct (247.3 ± 18.4 N versus 210.9 ± 10.4 N; p = .04). With cyclic failure testing, the biplanar plate construct with tension-side fixation endured a significantly greater number of cycles (206,738 ± 49,103 versus 101,780 ± 43,273; p < .001) and a significantly greater dynamic failure load (207.5 ± 24.3 N versus 162.5 ± 20.6 N; p < .001) compared with the straight biplanar plate construct. These results have demonstrated that under simulated static and cyclic Lapidus arthrodesis loading, biplanar plating with tension-side fixation provides superior strength compared with the straight biplanar construct. Thus, this construct shows promise for clinical application as a practical approach to tension-side fixation and an early return to weightbearing after Lapidus fusion.

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Published In

J Foot Ankle Surg

DOI

EISSN

1542-2224

Publication Date

2018

Volume

57

Issue

4

Start / End Page

766 / 770

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Plantar Plate
  • Orthopedics
  • Humans
  • Hallux Valgus
  • Cadaver
  • Bone Plates
  • Arthrodesis
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science
 

Citation

APA
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ICMJE
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Dayton, P., Hatch, D. J., Santrock, R. D., & Smith, B. (2018). Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion. J Foot Ankle Surg, 57(4), 766–770. https://doi.org/10.1053/j.jfas.2018.02.012
Dayton, Paul, Daniel J. Hatch, Robert D. Santrock, and Bret Smith. “Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion.J Foot Ankle Surg 57, no. 4 (2018): 766–70. https://doi.org/10.1053/j.jfas.2018.02.012.
Dayton P, Hatch DJ, Santrock RD, Smith B. Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion. J Foot Ankle Surg. 2018;57(4):766–70.
Dayton, Paul, et al. “Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion.J Foot Ankle Surg, vol. 57, no. 4, 2018, pp. 766–70. Pubmed, doi:10.1053/j.jfas.2018.02.012.
Dayton P, Hatch DJ, Santrock RD, Smith B. Biomechanical Characteristics of Biplane Multiplanar Tension-Side Fixation for Lapidus Fusion. J Foot Ankle Surg. 2018;57(4):766–770.
Journal cover image

Published In

J Foot Ankle Surg

DOI

EISSN

1542-2224

Publication Date

2018

Volume

57

Issue

4

Start / End Page

766 / 770

Location

United States

Related Subject Headings

  • Weight-Bearing
  • Plantar Plate
  • Orthopedics
  • Humans
  • Hallux Valgus
  • Cadaver
  • Bone Plates
  • Arthrodesis
  • 4207 Sports science and exercise
  • 4201 Allied health and rehabilitation science