Biomechanical evaluation of sanders type IIB calcaneal fractures: A cadaveric analysis of fixation strategies.

INTRODUCTION

Calcaneal fractures present significant treatment challenges due to their complex anatomy and load-bearing function. Increasingly, minimally invasive techniques are used in treatment. This study evaluates the biomechanical performance of 3 different fixation methods using embalmed cadaver calcanei subjected to a controlled linear increase in load.

METHODS

18 cadaveric calcanei were dissected and a simulated Sanders IIB joint depression calcaneal fracture was created with a saw. The fixation techniques used were: plate and 6.5 mm longitudinal screws, plate alone, and screws alone. Biomechanical testing was conducted using a uniaxial loading machine to assess stability, load transmission, and fragment displacement characteristics.

RESULTS

There was no statistically significant difference in the force/energy to failure between fixation types. Plate fixation did not result in any displacement of the fracture fragments in all specimens tested. Failure of fixation occurred in both screw fixation and plate with screw fixation, predominantly affecting the anterior process.

CONCLUSIONS

In this cadaver model, minimally invasive techniques provide similar stability of fracture fixation with uniaxial loading to plate fixation, however further consideration of fixation of the anterior process may be required with minimally invasive techniques.