Rights statement: This is the author’s version of a work that was accepted for publication in The Journal of Foot and Ankle Surgery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Journal of Foot and Ankle Surgery, ?, ?,, 2021 DOI: 10.1053/j.jfas.2021.07.017
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Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Comparison of Fixation Techniques in Oblique and Biplanar Chevron Medial Malleolar Osteotomies
T2 - a Finite Element Analysis
AU - Levent, Ali
AU - Yapti, Metin
AU - Celik, H Kursat
AU - Kose, Ozkan
AU - Kılıçaslan, Ömer Faruk
AU - Rennie, Allan
N1 - This is the author’s version of a work that was accepted for publication in The Journal of Foot and Ankle Surgery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in The Journal of Foot and Ankle Surgery, ?, ?,, 2021 DOI: 10.1053/j.jfas.2021.07.017
PY - 2021/7/23
Y1 - 2021/7/23
N2 - This study aimed to evaluate different fixation techniques and implants in oblique and biplanar chevron medial malleolar osteotomies using finite element analysis. Both oblique and biplanar chevron osteotomy models were created, and each osteotomy was fixed with two different screws (3.5 mm cortical screw and 4.0 mm malleolar screw) in two different configurations; (1) two perpendicular screws, and (2) an additional third transverse screw. Nine simulation scenarios were set up, including eight osteotomy fixations and the intact ankle. A bodyweight of 810.44 N vertical loading was applied to simulate a single leg stand on a fixed ankle. Sliding, separation, frictional stress, contact pressures between the fragments were analyzed. Maximum sliding (58.347µm) was seen in oblique osteotomy fixed with two malleolar screws, and the minimum sliding (17.272 µm) was seen in chevron osteotomy fixed with three cortical screws. The maximum separation was seen in chevron osteotomy fixed with two malleolar screws, and the minimum separation was seen in oblique osteotomy fixed with three cortical screws. Maximum contact pressure and the frictional stress at the osteotomy plane were obtained in chevron osteotomy fixed with three cortical screws. The closest value to normal tibiotalar contact pressures was obtained in chevron osteotomy fixed with three cortical screws. This study revealed that cortical screws provided better stability compared to malleolar screws in each tested osteotomy and fixation configuration. The insertion of the third transverse screw decreased both sliding and separation. Biplanar chevron osteotomy fixed with three cortical screws was the most stable model.
AB - This study aimed to evaluate different fixation techniques and implants in oblique and biplanar chevron medial malleolar osteotomies using finite element analysis. Both oblique and biplanar chevron osteotomy models were created, and each osteotomy was fixed with two different screws (3.5 mm cortical screw and 4.0 mm malleolar screw) in two different configurations; (1) two perpendicular screws, and (2) an additional third transverse screw. Nine simulation scenarios were set up, including eight osteotomy fixations and the intact ankle. A bodyweight of 810.44 N vertical loading was applied to simulate a single leg stand on a fixed ankle. Sliding, separation, frictional stress, contact pressures between the fragments were analyzed. Maximum sliding (58.347µm) was seen in oblique osteotomy fixed with two malleolar screws, and the minimum sliding (17.272 µm) was seen in chevron osteotomy fixed with three cortical screws. The maximum separation was seen in chevron osteotomy fixed with two malleolar screws, and the minimum separation was seen in oblique osteotomy fixed with three cortical screws. Maximum contact pressure and the frictional stress at the osteotomy plane were obtained in chevron osteotomy fixed with three cortical screws. The closest value to normal tibiotalar contact pressures was obtained in chevron osteotomy fixed with three cortical screws. This study revealed that cortical screws provided better stability compared to malleolar screws in each tested osteotomy and fixation configuration. The insertion of the third transverse screw decreased both sliding and separation. Biplanar chevron osteotomy fixed with three cortical screws was the most stable model.
KW - finite element analysis
KW - medial malleolar osteotomy
KW - screw fixation
KW - biplanar chevron osteotomy
KW - oblique osteotomy
KW - biomechanics
U2 - 10.1053/j.jfas.2021.07.017
DO - 10.1053/j.jfas.2021.07.017
M3 - Journal article
JO - The Journal of Foot and Ankle Surgery
JF - The Journal of Foot and Ankle Surgery
SN - 1067-2516
M1 - YJFAS 53575
ER -