Investigation of the Characteristics and Mechanism of Interosseous Membrane Injuries in Typical Maisonneuve Fracture

Biplane Reduction: A Novel Technique for Restoring Fibula Length in Maisonneuve Fracture

OBJECTIVE

Fibular length is important for ankle stability. Failure to adequately restore and stabilize fibula length may result in malunion, hindering postoperative functional exercises and recovery of ankle function. However, there is no unified and effective reduction method for fibular shortening in Maisonneuve fractures. In this study, we introduce the biplane reduction as an effective surgical technique for restoring the length of the fibula in Maisonneuve fractures.

METHODS

This retrospective study enrolled 12 patients preoperatively diagnosed with Maisonneuve fractures between June 2019 and June 2022. All patients underwent our biplane reduction technique to restore the length of their fibula. Operation time, hospital stay, complications, FTA (the angle between the fibular tip and the superior articular surface of the talus), visual analog pain score, and the American Orthopaedic Foot and Ankle Society ankle-hindfoot score were recorded. An independent sample t-test was used for component comparisons, and a paired sample t-test or one-way analysis of variance was used for intra-group comparisons.

RESULTS

No patient was lost to follow-up and no obvious postoperative complications were observed. After operation, FTA recovered from 37.52 ± 0.37 ° to 40.42 ± 0.43 °, which was significantly improved compared with that before operation (p < 0.01). At the last follow-up, both the VAS and AOFAS scores showed significant improvement compared to pre-surgery scores.

CONCLUSIONS

The reduction technique proposed in this study to restore the length of the fibula in Maisonneuve fractures is simple and effective, does not require special equipment, and has the advantage of directly examining the reduction condition.

Three‑dimensional finite element analysis: Anatomical splint fixation for Colles fractures

With the rapid development of digital research in clinical orthopedics, the efficacy and safety of splint fixation can be better evaluated through biomechanical analysis based on a three-dimensional (3D) finite element model. It is essential to address the current gap in understanding the biomechanical implications of anatomical splint fixation for Colles fractures. By employing advanced 3D finite element analysis, the present study aimed to provide a comprehensive evaluation, offering valuable insights that can contribute to enhancing the effectiveness of anatomical splint fixation in the clinical management of Colles fractures. The 3D finite element models of the forearm and hand were constructed using Mimics 15.0 according to data from computed tomography of a patient with a Colles fracture. After the validity of the model was verified, the corresponding material properties of the models were adjusted to simulate a Colles fracture. Subsequently, the reduction functions, such as radial inclination and ulnar deviation, of the simulated fracture were completed and the mechanical changes of the tissues surrounding the fracture were calculated. Anatomical splints were then placed on the surfaces of the 3D finite element models of Colles fractures at various positions to analyze the changes in the stress cloud diagram, such as for the soft tissue and anatomical splints. In the present study, the constructed 3D finite element models were accurate and valid. The maximum stress of the anatomical splints and soft tissues was 2.346 and 0.106 MPa in pronation, 1.780 and 0.069 MPa in median rotation and 3.045 and 0.057 MPa in supination, respectively. Splint stress reached the highest level in supination and soft tissue stress achieved the highest level in pronation. The peak of splint stress occurred during supination, which contrasts to the peak of soft tissue stress observed in pronation, suggesting splint fixation median rotation can effectively avoid compression of the local soft tissue.