Biomechanical analysis of endobutton versus screw fixation after Lisfranc ligament complex sectioning

Marsland, Daniel; Belkoff, Stephen M.; Solan, Matthew C.

Affiliations

¹International Center for Orthopaedic Advancement, The Johns Hopkins University, Baltimore, MD, USA

Abstract and keywords

Background: Our goal was to compare diastasis after endobutton and screw fixation after Lisfranc ligament complex sectioning.

Methods: Twenty-four (12 pairs) fresh-frozen cadaveric feet were assigned to endobutton or screw fixation and loaded to 343 N. Displacement (first–second metatarsal bases) was measured in intact feet and after ligament sectioning (Lisfranc, medial–intermediate cuneiform ligaments), fixation, and 10,000 cycles.

Results: The mean change in diastasis for endobutton and screw fixation under initial loading was 1.0 mm (95% CI, 0.2–1.9 mm) and 0.0 mm (95% CI, −0.4 to 0.4 mm), respectively (p = 0.017). After cyclic loading, diastasis decreased (mean, −0.7 mm, 95% CI, −1.2 to −0.1 mm) in the endobutton group but was unchanged in the screw group (p = 0.035).

Conclusions: Diastasis after endobutton fixation was significantly greater than after screw fixation under initial loading but did not increase further after cyclic loading.

Keywords: Lisfranc ligament rupture; Endobutton; Biomechanical; Screw

Links

DOI: 10.1016/j.fas.2013.06.009

PubMed: 24095236

History

Received: 2013-03-12

Revised: 2013-06-21

Accepted: 2013-06-25

Online: 2013-07-19

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Cited By (2)

Year	Entry
2015	Lievers WB, Frimenko RE, McCullough KA, Crandall JR, Kent RW. Etiology and biomechanics of midfoot (Lisfranc) injuries in athletes. Crit Rev Biomed Eng. 2015;43(2-3):213-238.
2022	Perez MT, Owen JR, Adelaar RS, Wayne JS. Computational analysis of Lisfranc surgical repairs. J Orthop Res. December 2022;40(12):2856-2864.