Combined vertical and external rotational force in plantarflexion position produces posterior pilon fracture: A preliminary cadaveric study

IF 1.9 3区 医学 Q2 ORTHOPEDICS Foot and Ankle Surgery Pub Date : 2024-07-01 DOI:10.1016/j.fas.2024.02.010
Genrui Zhu , Shengxuan Cao , Jun Zhu , Chengjie Yuan , Zhifeng Wang , Jiazhang Huang , Xin Ma , Xu Wang
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Abstract

Background

Posterior pilon fracture is speculated to occur by a combination of rotation and axial load, which makes it different from rotational posterior malleolar fracture or pilon fracture, but is not validated in vitro. The aim of the current study is to investigate the injury mechanisms of posterior pilon fracture on cadaveric specimens.

Methods

Eighteen cadaveric specimens were mounted to a loading device to undergo solitary vertical loading, solitary external rotational loading, and combined vertical and external rotational loading until failure, in initial position of plantarflexion with or without varus. The fracture characteristics were documented for each specimen.

Results

Vertical loading force combined with external rotation force diversified the fracture types resulting in pilon fracture, tibial spiral fracture, rotational malleolar fracture, talar fracture or calcaneal fracture. Vertical violence combined with external rotational loading in position of 45° of plantarflexion and 0° of varus produced posterior pilon fracture in specimens No. 13 and 14.

Conclusion

Combination of vertical and external rotational force in plantarflexion position on cadaveric specimens produce posterior pilon fracture.

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跖屈位时的垂直和外旋联合力会导致后皮隆骨折:尸体初步研究
据推测,Pilon 后骨折是由旋转和轴向载荷共同作用造成的,这使其有别于旋转性踝后骨折或 pilon 骨折,但未在体外进行验证。本研究的目的是在尸体标本上研究后枕骨骨折的损伤机制。研究人员将 18 个尸体标本安装在加载装置上,在跖屈或不跖屈的初始位置,分别进行单独垂直加载、单独外旋加载以及垂直和外旋联合加载,直至骨折。每个试样的骨折特征都有记录。垂直加载力与外旋力相结合使骨折类型多样化,导致皮隆骨折、胫骨螺旋形骨折、旋转踝骨骨折、距骨骨折或小腿骨骨折。13 号和 14 号试样在跖屈 45°、屈曲 0°的位置上受到垂直暴力和外旋加载,导致后皮隆骨折。在尸体标本上,跖屈位置的垂直力和外旋力相结合会造成后Pilon骨折。
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来源期刊
Foot and Ankle Surgery
Foot and Ankle Surgery ORTHOPEDICS-
CiteScore
4.60
自引率
16.00%
发文量
202
期刊介绍: Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society. The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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