PDF(Pubmed)
Abstract：
UNASSIGNED: Lisfranc injuries are often treated with open reduction and internal fixation using rigid fixation techniques. The use of flexible fixation to stabilize the Lisfranc joint is a newer technique. The purpose of this cadaveric study is to compare the amount of diastasis at the Lisfranc interval under diminished physiologic loads when treated with a knotless suture tape construct and a solid screw.
UNASSIGNED: Ten cadavers (20 feet) had native motion at the intact Lisfranc interval assessed at multiple increasing loads (69, 138, and 207 N). The Lisfranc ligamentous complex was then disrupted, and testing repeated to evaluate the amount of diastasis. Randomization was performed to determine the type of fixation for each cadaver: solid screw or knotless suture tape construct. Once fixation was completed, specimens were cyclically loaded for 10 000 cycles at loads, and diastasis was quantified after each load cycle to compare the interventions. Diastasis was measured using motion tracking cameras and retroreflective marker sets. A non-inferiority statistical analysis was performed.
UNASSIGNED: Diastasis mean values were confirmed to be >2 mm for all load bearing conditions in the injury model. Posttreatment, diastasis was significantly reduced when compared to the sectioned conditions (P < .01) for both treatment options. Non-inferiority analyses showed that the knotless suture tape construct did not perform inferior to screw fixation for diastasis at the Lisfranc interval at any of the compared load states.
UNASSIGNED: Under the loads tested, there is no significant difference in diastasis at the Lisfranc interval when treating ligamentous Lisfranc injuries with a knotless suture tape construct or solid screws. Both reduced diastasis from the injured state and were not different from the intact state.
UNASSIGNED: In this cadaveric model with ligamentous Lisfranc injury, diastasis of a knotless suture tape construct is compared to solid screw fixation as tested.
UNASSIGNED: Ten cadavers (20 feet) had native motion at the intact Lisfranc interval assessed at multiple increasing loads (69, 138, and 207 N). The Lisfranc ligamentous complex was then disrupted, and testing repeated to evaluate the amount of diastasis. Randomization was performed to determine the type of fixation for each cadaver: solid screw or knotless suture tape construct. Once fixation was completed, specimens were cyclically loaded for 10 000 cycles at loads, and diastasis was quantified after each load cycle to compare the interventions. Diastasis was measured using motion tracking cameras and retroreflective marker sets. A non-inferiority statistical analysis was performed.
UNASSIGNED: Diastasis mean values were confirmed to be >2 mm for all load bearing conditions in the injury model. Posttreatment, diastasis was significantly reduced when compared to the sectioned conditions (P < .01) for both treatment options. Non-inferiority analyses showed that the knotless suture tape construct did not perform inferior to screw fixation for diastasis at the Lisfranc interval at any of the compared load states.
UNASSIGNED: Under the loads tested, there is no significant difference in diastasis at the Lisfranc interval when treating ligamentous Lisfranc injuries with a knotless suture tape construct or solid screws. Both reduced diastasis from the injured state and were not different from the intact state.
UNASSIGNED: In this cadaveric model with ligamentous Lisfranc injury, diastasis of a knotless suture tape construct is compared to solid screw fixation as tested.
摘要：
■Lisfranc损伤通常使用刚性固定技术进行切开复位和内固定治疗。使用柔性固定来稳定Lisfranc关节是一种较新的技术。这项尸体研究的目的是比较用无结缝合带构造和实心螺钉治疗时，在生理负荷减少的情况下，Lisfranc间隔的舒张量。
■十个尸体（20英尺）在多次增加的载荷（69、138和207N）下评估的完整Lisfranc间隔内具有自然运动。Lisfranc韧带复合体随后被破坏，并重复测试以评估舒张量。进行随机化以确定每个尸体的固定类型：实心螺钉或无结缝合带构造。一旦固定完成,试样在载荷下循环加载10000个周期，并在每个负荷周期后对舒张进行量化，以比较干预措施。使用运动跟踪相机和回射标记集来测量偏移。进行非劣效性统计分析。
■对于损伤模型中的所有承重条件，确认了Distasis平均值>2mm。后处理,与两种治疗方案的切片条件（P<.01）相比，舒张率均显着降低。非劣效性分析表明，在任何比较的负载状态下，在Lisfranc间隔下，无结缝合带构造的脱位性能均不如螺钉固定。
■在测试的负载下，当使用无结缝合带结构或实心螺钉治疗韧带性Lisfranc损伤时，Lisfranc间隔的舒张没有显着差异。两者都减少了受伤状态的舒张，并且与完整状态没有区别。
■在这个韧带Lisfranc受伤的尸体模型中，将无结缝合带构造的扩张与测试的实心螺钉固定进行比较。
■十个尸体（20英尺）在多次增加的载荷（69、138和207N）下评估的完整Lisfranc间隔内具有自然运动。Lisfranc韧带复合体随后被破坏，并重复测试以评估舒张量。进行随机化以确定每个尸体的固定类型：实心螺钉或无结缝合带构造。一旦固定完成,试样在载荷下循环加载10000个周期，并在每个负荷周期后对舒张进行量化，以比较干预措施。使用运动跟踪相机和回射标记集来测量偏移。进行非劣效性统计分析。
■对于损伤模型中的所有承重条件，确认了Distasis平均值>2mm。后处理,与两种治疗方案的切片条件（P<.01）相比，舒张率均显着降低。非劣效性分析表明，在任何比较的负载状态下，在Lisfranc间隔下，无结缝合带构造的脱位性能均不如螺钉固定。
■在测试的负载下，当使用无结缝合带结构或实心螺钉治疗韧带性Lisfranc损伤时，Lisfranc间隔的舒张没有显着差异。两者都减少了受伤状态的舒张，并且与完整状态没有区别。
■在这个韧带Lisfranc受伤的尸体模型中，将无结缝合带构造的扩张与测试的实心螺钉固定进行比较。
