Biomechanical comparison of “two-point fixation” and “three-point fixation” in the treatment of intra-articular calcaneal fracture

1.University of Shanghai for Science and Technology;2.Shanghai Pudong New Area Peoples’ Hospital;3.Medical College of Tongji University

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Shanghai pudong new area health system outstanding academic leader project

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    Objective This study proposed and analyzed the biomechanical feasibility of the "two-point fixation" by distal radius plate for the treatment of intra-articular calcaneal fractures, and provided suggestions for the clinical treatment. Method A three-dimensional finite element (FE) musculoskeletal foot model was established based on CT and MRI images, which comprised bones, muscles, plantar fascia, ligaments and soft tissues. After validation of the FE model, we established the Sanders III calcaneal fracture model and fixed by distal radial plate (two-point fixation) and calcaneal plate (three-point fixation). The biomechanical characteristics of two calcaneal models were compared using ABAQUS software. Result The maximum stress of the "two-point fixation MPa, which is smaller compared to the "three-point fixed" model (407.90MPa).The maximum displacement of the two models are 2.498mm and 2.541mm, respectively. The longitudial displacement and vertical displacement of the former is greater than the latter, but the transverse displacement is less than the latter. There was no significant difference in the posterior articular surface displacement between the two models. In both models, the Bohler"s Angle and Gissane"s Angle were within the normal range. Conclusion The "two-point fixation" by distal radial plate can satisfy the biomechanical stability of calcaneal fracture treatment and the overall stress distribution of the fracture model is uniform. Patients can carry out early weight-bearing rehabilitation after surgery. The "two-point fixation" is a novel recommended treatment for the treatment of calcaneal fractures.

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  • Received:February 14,2020
  • Revised:March 13,2020
  • Adopted:March 17,2020
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