Biomechanical evaluation of polylactide absorbable screws used for syndesmosis injury repair

Thordarson, David B.; Hedman, Thomas P.; Gross, Dominic; Magre, George

Affiliations

¹Department of Orthopaedics, University of Southern California, Los Angeles, California 90033

²Department of Radiology, University of Southern California, Los Angeles, California 90033

Abstract

Simulated syndesmosis injuries were created in 12 fresh-frozen, below-knee cadaver specimens. Six specimens were repaired with a 4.5 mm stainless steel screw, and six were repaired with a 4.5 mm polylactide screw. Three specimens of each group were tested in load to failure by axially loading with 1400 N and externally rotating to 90 degrees. Three specimens in each group underwent fatigue testing by axially loading with 700 N and applying 2.5 N-m of torque for 57,700 cycles. Radiographs and computed tomography scans were evaluated. None of the screws broke or failed. Similar load to failure was noted in polylactide and control groups. Fatigue testing revealed no significant change in stiffness. No significant screw damage was evident on radiographic or computed tomography evaluation. The data suggest that a polylactide screw has sufficient fatigue and failure strength to allow for healing of this injury in a clinical situation.

Links

PubMed: 9347298

WoS: A1997YB59300004

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Cited By (13)

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2009	DeOrio M, Erickson M, Usuelli FG, Easley M. Lisfranc injuries in sport. Foot and Ankle Clinics. June 2009;14(2):169-186.
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2000	Thompson MC, Gesink DS. Biomechanical comparison of syndesmosis fixation with 3.5- and 4.5-millimeter stainless steel screws. Foot Ankle Int. September 2000;21(9):736-741.
2001	Thordarson DB, Samuelson M, Shepherd LE, Merkle PF, Lee J. Bioabsorbable versus stainless steel screw fixation of the syndesmosis in pronation-lateral rotation ankle fractures: a prospective randomized trial. Foot Ankle Int. April 2001;22(4):335-338.
2005	Marqueen T, Owen J, Nicandri G, Wayne J, Carr J. Comparison of the syndesmotic staple to the transsyndesmotic screw: a biomechanical study. Foot Ankle Int. March 2005;26(3):224-230.
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2007	van den Bekerom MPJ, Raven EEJ. Current concepts review: operative techniques for stabilizing the distal tibiofibular syndesmosis. Foot Ankle Int. December 2007;28(12):1302-1308.
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