Biomechanical comparison of malleol screw,bicortical screw,tension band and ready tension band in medial malleol transvers fractures

Ankle fracture is one of the most common musculoskeletal problems in injuries which commonly seen in middle-aged - young male population (20-39 years) and in older women (50-69 years). While most of the fractures are stable and isolated malleolus fractures and treated with conservative treatment, unstable fractures usually require surgery. Although the timing of surgery is controversial, patients are mobilized sooner by early surgical treatment. At present malleolus screw, bicortical screws, tension band methods are used for medial malleolus transverse fractures which is a kind of ankle fracture and often require surgical intervention. In this study, biomechanical comparison of the ready tension band, which is a new method for transverse medial malleolus fracture, with malleolus screws, bicortical screw and tension band is aimed. Anterior tibia bones of cows which is cut for consumption at 2 years old, ere stripped from soft tissue and 24 cow tibias were obtained. Each of these tibia was cut with electric saws from 15 cm proximal of the tibiotalar joint surface and proximal parts were exculeded from the study. Transverse fracture line was created with osteotome on medial side of remaining distal tibia parts and separated into 4 groups which containing 6 distal tibia. Malleolus screw, bicortical screw, belt tensioners and ready belt tensioners duly placed to the transverse fragment of medial malleolus of distal tibia with scopy. Samples were frozen by biomechanical deformation and analysis resistant polythene mold at Kocaeli University Faculty of Engineering at the biomechanics laboratory. Borders of freezing were the distal parts of the osteotome line with not to exceeding line. The groups were tested with test equipment capable of digital analysis of axial load and deformation. While Ready Tension Band was more durable and resisted to higher catastrophic damage forces then other three methods (bicortical screws, screw malleoli, Tension Band), there was no significant difference between them in terms of displacement forces. Our method biomechanically has been found successful for forces applied in the transverse section as compared to other methods. Ready Tension Band method was resisted to higher catastrophic damage forces applied in axial section compared to other two methods (Screw malleolus, Tension Band) and found more durable than other three methods in forces applied axial section.