Authors
Ying Zhang, Zhenjun Zhang, Pan Hao, Bin Li, Zhaorui Liu
Published in
The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons. Oct 11, 2026. Epub Oct 11, 2026.
Abstract
Optimal fixation for Herscovici type B and type C medial malleolar fractures because of debated due to differences in fragment size and loading conditions.
This study introduces the theoretical concept of Internal Fixation Bone Mass Index (IFBM) and compares three fixation methods under multidirectional loading.
Biomechanical study using Synbone® artificial tibia models.
Synbone® tibia models simulated type B (small fragment, n=27) and type C (large fragment, n=27) fractures. Three fixation methods-cannulated screws (CS, 4.0 mm), fully threaded cancellous screws (FTCS, 4.0 mm), and Kirschner wires (KW, 1.5 mm)-were tested under axial, transverse, and traction loading using an Instron® 5969 machine. IFBM was defined as A_implant/A_bone.
For type B fractures, KW showed a higher 2 mm displacement load under traction than CS (65 ± 11 N vs. 31 ± 9 N; post-hoc p = 0.008) and FTCS (65 ± 11 N vs. 36 ± 12 N; post-hoc p = 0.012), with no statistically significant difference under axial and transverse loading (ANOVA p = 0.231 and p = 0.501). For type C fractures, CS and FTCS showed higher stability than KW under transverse and traction loading (ANOVA p = 0.004 and p = 0.003); no statistically significant difference was detected under axial loading (ANOVA p = 0.167).
Fixation performance differed by fracture type. KW showed favorable performance for type B fractures, whereas screw fixation (CS or FTCS) demonstrated superior performance for type C fractures. IFBM is a theoretical metric that requires clinical validation.
PMID:
42860174
Bibliographic data and abstract were imported from PubMed on 12 Oct 2026.
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