title: Are Hook Plates Advantageous Compared to Antiglide Plates for Vertical Shear Malleolar Fractures?
abstract: This study was designed to evaluate the biomechanical properties of a hook plate (HP) vs an antiglide (AG) plate for supination-adduction (SAD)-ankle fractures. Identical polyurethane tibial models were obtained and vertical fractures were created. The fractures were stabilized with 1 of the following: one-third tubular plate in an AG fashion with 2 screws proximal to the fracture; an AG plate with an additional screw perpendicular to the vertical shear fragment (MAG), or an HP. Ten models were randomly assigned to each of the 3 groups. The constructs were tested in offset-axial loading and were evaluated for construct stiffness and load-to-failure. The MAG construct yielded better stiffness compared with the AG plate (P < .05) and the HP (P < .05). The plate stiffness of the HP construct compared with the AG was not significant (P = .350). In regards to load-to-failure, the difference between MAG and AG was 638 N, and MAG and HP was 530 N (both P < .05). The HP had a load-to-failure that was, on average, 108 N more than the AG but was not significant (P = .063). A one-third tubular plate in the MAG fashion provided a stable, strong construct for fixation of vertical shear medial malleolus fractures.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Jones
authors.affiliation: Department of Orthopaedic Surgery, Saint Louis University, St. Louis, MO. lcannada@slu.edu.
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Cannada
authors.forename: J Gary
authors.initials: JG
authors.lastname: Bledsoe
mesh_terms: D064386:Ankle Fractures / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D001860:Bone Plates; D006801:Humans; D008953:Models, Anatomic