Skip to main content
SpringerLink
Log in

Biomechanical evaluation of reconstruction plates with locking, nonlocking, and hybrid screws configurations in calcaneal fracture: a finite element model study

  • Original Article
  • Published:
Medical & Biological Engineering & Computing Aims and scope Submit manuscript

Abstract

Calcaneal fractures are the most common fractures of the tarsal bones. The stability of fixation is an important factor for successful reconstruction of calcaneal fractures. The purpose of this study was to analyze the biomechanical influence of plate fixation with different combinations of locking and nonlocking screws during early weight-bearing phase. A three-dimensional FE foot model was established using ANSYS software, which comprised bones, cartilages, plantar fascia, and soft tissue. Calcaneal plate was fixed with whole locking (WLS), whole nonlocking (WNS), and hybrid screw configurations for FE analysis. The WNS generated a 6.1° and 2.2° Bohler angle decrease compared with the intact model and WLS (WNS: 18.9; WLS: 21.1; intact: 25.0°). Some hybrid screw configurations (Bohler angle: 21.5° and 21.2°) generated stability similar to WLS. The FE results showed that the fragments at the posterior facet and the posterior tuberosity sustained more stress. This study recommends that the hybrid screw configuration with at least four locking screws, two at the posterior facet fragment and two at the posterior tuberosity fragment, is the optimal choice for the fixation of Sanders type IIB calcaneal fractures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Blake MH, Owen JR, Sanford TS, Wayne JS, Adelaar RS (2011) Biomechanical evaluation of a locking and nonlocking reconstruction plate in an osteoporotic calcaneal fracture model. Foot Ankle Int 32:432–436

    Article  PubMed  Google Scholar 

  2. Brilakis E, Kaselouris E, Xypnitos F, Provatidis CG, Efstathopoulos N (2012) Effects of foot posture on fifth metatarsal fracture healing: a finite element study. J Foot Ankle Surg 51:720–728

    Article  PubMed  Google Scholar 

  3. Chapman J, Harrington R, Lee K, Anderson P, Tencer A, Kowalski D (1996) Factors affecting the pullout strength of cancellous bone screws. J Biomech Eng 118:391–398

    Article  CAS  PubMed  Google Scholar 

  4. Chen K, Zhang H, Wang G, Cheng Y, Qian Z, Yang H (2014) Comparison of nonlocking plates and locking plates for intraarticular calcaneal fracture. Foot Ankle Int 35:1298–1302

    Article  PubMed  Google Scholar 

  5. Chen W-M, Lee T, Lee PV-S, Lee JW, Lee S-J (2010) Effects of internal stress concentrations in plantar soft-tissue—a preliminary three-dimensional finite element analysis. Med Eng Phys 32:324–331

    Article  PubMed  Google Scholar 

  6. Cheung JT-M, An K-N, Zhang M (2006) Consequences of partial and total plantar fascia release: a finite element study. Foot Ankle Int 27:125–132

    Article  PubMed  Google Scholar 

  7. Coughlin MJ, Mann RA, Saltzman CL, Anderson RB (2007) Surgery of the foot and ankle. Mosby Inc, Philadelphia, PA

  8. Hirschmüller A, Konstantinidis L, Baur H, Müller S, Mehlhorn A, Kontermann J, Grosse U, Südkamp N, Helwig P (2011) Do changes in dynamic plantar pressure distribution, strength capacity and postural control after intra-articular calcaneal fracture correlate with clinical and radiological outcome? Injury 42:1135–1143

    Article  PubMed  Google Scholar 

  9. Hsiao H, Guan J, Weatherly M (2002) Accuracy and precision of two in-shoe pressure measurement systems. Ergonomics 45:537–555

    Article  PubMed  Google Scholar 

  10. Hsu Y-C, Gung Y-W, Shih S-L, Feng C-K, Wei S-H, C-h Yu, Chen C-S (2008) Using an optimization approach to design an insole for lowering plantar fascia stress—a finite element study. Ann Biomed Eng 36:1345–1352

    Article  PubMed  Google Scholar 

  11. Hyer CF, Atway S, Berlet GC, Lee TH (2010) Early weight bearing of calcaneal fractures fixated with locked plates: a radiographic review. Foot Ankle Spec 3:320–323. doi:10.1177/1938640010374121

    Article  PubMed  Google Scholar 

  12. Illert T, Rammelt S, Drewes T, Grass R, Zwipp H (2011) Stability of locking and non-locking plates in an osteoporotic calcaneal fracture model. Foot Ankle Int 32:307–313

    Article  PubMed  Google Scholar 

  13. Isvilanonda V, Dengler E, Iaquinto JM, Sangeorzan BJ, Ledoux WR (2012) Finite element analysis of the foot: model validation and comparison between two common treatments of the clawed hallux deformity. Clin Biomech 27:837–844

    Article  Google Scholar 

  14. Jastifer JR (2014) Topical review locking plate technology in foot and ankle surgery. Foot Ankle Int 35(5):512–518. doi:10.1177/1071100714523274

    Article  PubMed  Google Scholar 

  15. Kienast B, Gille J, Queitsch C, Kaiser M, Thietje R, Juergens C, Schulz A (2009) Early weight bearing of calcaneal fractures treated by intraoperative 3D-fluoroscopy and locked-screw plate fixation. Open Orthop J 3:69

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Lemmon D, Shiang T, Hashmi A, Ulbrecht JS, Cavanagh PR (1997) The effect of insoles in therapeutic footwear—a finite element approach. J Biomech 30:615–620

    Article  CAS  PubMed  Google Scholar 

  17. Nakamura S, Crowninshield R, Cooper R (1980) An analysis of soft tissue loading in the foot—a preliminary report. Bull Prosthet Res 10:27–34

    Google Scholar 

  18. Pang Q-j YuX, Z-h Guo (2014) The sustentaculum tali screw fixation for the treatment of Sanders type II calcaneal fracture: a finite element analysis. Pak J Med Sci 30:1099

    PubMed  PubMed Central  Google Scholar 

  19. Pendergast M, Rusovici R (2015) A finite element parametric study of clavicle fixation plates. Int J Numer Methods Biomed Eng 31(6):e02710

    Article  Google Scholar 

  20. Redfern DJ, Oliveira ML, Campbell JT, Belkoff SM (2006) A biomechanical comparison of locking and nonlocking plates for the fixation of calcaneal fractures. Foot Ankle Int 27:196–201

    Article  PubMed  Google Scholar 

  21. Richter M, Gosling T, Zech S, Allami M, Geerling J, Droste P, Krettek C (2005) A comparison of plates with and without locking screws in a calcaneal fracture model. Foot Ankle Int 26:309–319

    Article  PubMed  Google Scholar 

  22. Sangeorzan BJ, Ananthakrishnan D, Tencer AF (1995) Contact characteristics of the subtalar joint after a simulated calcaneus fracture. J Orthop Trauma 9:257–258

    Article  Google Scholar 

  23. Schepers T, van Lieshout E, Van Ginhoven T, Heetveld M, Patka P (2008) Current concepts in the treatment of intra-articular calcaneal fractures: results of a nationwide survey. Int Orthop 32:711–715

    Article  CAS  PubMed  Google Scholar 

  24. Siegler S, Block J, Schneck CD (1988) The mechanical characteristics of the collateral ligaments of the human ankle joint. Foot Ankle Int 8:234–242

    Article  CAS  Google Scholar 

  25. Simkin A (1982) Structural analysis of the human foot in standing posture. Tel-Aviv University, Tel-Aviv

    Google Scholar 

  26. Stoffel K, Booth G, Rohrl SM, Kuster M (2007) A comparison of conventional versus locking plates in intraarticular calcaneus fractures: a biomechanical study in human cadavers. Clin Biomech 22:100–105

    Article  Google Scholar 

  27. Sun P-C, Shih S-L, Chen Y-L, Hsu Y-C, Yang R-C, Chen C-S (2012) Biomechanical analysis of foot with different foot arch heights: a finite element analysis. Comput Methods Biomech Biomedi Eng 15:563–569

    Article  Google Scholar 

  28. Terrier A, Kochbeck S, Merlini F, Gortchacow M, Pioletti DP, Farron A (2010) Tightening force and torque of nonlocking screws in a reverse shoulder prosthesis. Clin Biomech 25:517–522

    Article  CAS  Google Scholar 

  29. Wang Y, Li Z, Zhang M (2014) Biomechanical study of tarsometatarsal joint fusion using finite element analysis. Med Eng Phys 36:1394–1400

    Article  PubMed  Google Scholar 

  30. Wright D, Rennels D (1964) A study of the elastic properties of plantar fascia. J Bone Joint Surg Am 46:482–492

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

This study was supported partly by Taipei Veterans General Hospital (V104C-177) and by Ministry of Science and Technology, R.O.C. (MOST 104-2314-B-075-002).

Author information

Authors and Affiliations

  1. Department of Mechanical Engineering, National Chiao Tung University, Hsinchu, Taiwan

    Ching-Hsuan Chen & Chinghua Hung

  2. College of Medicine and Engineering, Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan

    Yu-Chun Hsu

  3. Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei, Taiwan

    Chen-Sheng Chen

  4. Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan

    Chao-Ching Chiang

  5. Department of Surgery, School of Medicine, National Yang-Ming University, Taipei, Taiwan

    Chao-Ching Chiang

Authors
  1. Ching-Hsuan Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chinghua Hung
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yu-Chun Hsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chen-Sheng Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chao-Ching Chiang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chao-Ching Chiang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, CH., Hung, C., Hsu, YC. et al. Biomechanical evaluation of reconstruction plates with locking, nonlocking, and hybrid screws configurations in calcaneal fracture: a finite element model study. Med Biol Eng Comput 55, 1799–1807 (2017). https://doi.org/10.1007/s11517-017-1623-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11517-017-1623-0

Keywords

Search

Navigation