nam 22 uu 4500 dbt_mods_00052567 10.3390/app12083833 doi dbt_mods_00052567 ger DE-601 rda eng 610 sdnb Kohler, Felix Christian Author aut Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany;(P.S.);(P.K.);(B.W.);(G.O.H.);(I.G.);(J.H.) (DE-588)1186095881 How the Direction of Screws Affects the Primary Stability of a Posterior Malleolus Osteosynthesis under Torsional Loading: A Biomechanical Study Kohler, Felix Christian;Schenk, Philipp;Koehler, Paul;Wildemann, Britt;Hofmann, Gunther Olaf;Derlien, Steffen;Biedermann, Uta;Graul, Isabel;Hallbauer, Jakob;Vadalà, Gianluca;Papalia, Rocco;Russo, Fabrizio;Denaro, Vincenzo;Zampogna, Biagio Basel MDPI 2022-04-11 7 Seiten text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Insufficient fixation of a posterior malleolus fracture (PM) can lead to posttraumatic complications such as osteoarthritis and chronic pain. The purpose of this biomechanical study was to test the hypothesis of whether the direction of PM screw fixation has an impact on the primary stability of osteosynthesis of a PM under torsional loading. PM fractures of 7 pairs human cadaveric lower leg specimens were stabilized with posterior to anterior (p.a.) or anterior to posterior (a.p.) screw fixation. Stability of the osteosynthesis was biomechanically tested using cyclic external torsional loading levels, in 2 Nm steps from 2 Nm up to 12 Nm, under constant monitoring with 3D ultrasonic marker (Zebris). The primary stability does not differ between both stabilizations ( p = 0.378) with a medium effect size (η 2 p = 0.065). The movement of the PM tends to be marginally greater for the osteosynthesis with a.p. screws than with p.a. screws. Whether a.p. screws or the alternative p.a. screw fixation is performed does not seem to have an influence on the primary stability of the osteosynthesis of the PM fixation under torsional loading. Although osteosynthesis from posterior seems to be more stable, the biomechanical results in the torsional test show quite equivalent stabilities. If there is no significant dislocation of the PM, a.p. screw fixation could be a minimally invasive but stable surgical strategy. posterior malleolus Volkmann triangle primary stability ankle fractures syndesmosis article Schenk, Philipp Author aut Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany;(P.S.);(P.K.);(B.W.);(G.O.H.);(I.G.);(J.H.) BG Klinikum Bergmannstrost, Research Executive Department, Merseburger Straße 165, 06112 Halle, Germany Koehler, Paul Author aut Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany;(P.S.);(P.K.);(B.W.);(G.O.H.);(I.G.);(J.H.) Wildemann, Britt Author aut Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany;(P.S.);(P.K.);(B.W.);(G.O.H.);(I.G.);(J.H.) (DE-588)120936208 Hofmann, Gunther Olaf Author aut Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany;(P.S.);(P.K.);(B.W.);(G.O.H.);(I.G.);(J.H.) BG Klinikum Bergmannstrost, Department of Trauma and Reconstructive Surgery, Merseburger Straße 165, 06112 Halle, Germany (DE-588)110673522 Derlien, Steffen Author aut Institute of Physiotherapy, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany; (DE-588)13916085X Biedermann, Uta Author aut Institute of Anatomy I, Jena University Hospital, Friedrich Schiller University Jena, 07743 Jena, Germany; Graul, Isabel Author aut Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany;(P.S.);(P.K.);(B.W.);(G.O.H.);(I.G.);(J.H.) (DE-588)1027367941 Hallbauer, Jakob Author aut Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany;(P.S.);(P.K.);(B.W.);(G.O.H.);(I.G.);(J.H.) Vadalà, Gianluca Editor edt (DE-588)1155558634 Papalia, Rocco Editor edt Russo, Fabrizio Editor edt (DE-588)1042930899 Denaro, Vincenzo Editor edt Zampogna, Biagio Editor edt Friedrich-Schiller-Universität Jena Medizinische Fakultät host institution his 12, 2022:8:3833<1 Technische Universität Ilmenau, Universitätsbibliothek Applied Sciences 2076-3417 dbt_mods_00031129 https://www.db-thueringen.de/receive/dbt_mods_00052567 object in context https://www.db-thueringen.de/servlets/MCRFileNodeServlet/dbt_derivate_00056660/applsci-12-03833.pdf raw object https://www.db-thueringen.de/rsc/thumbnail/dbt_mods_00052567.png preview https://www.db-thueringen.de/receive/dbt_mods_00052567 uri