117682 20230519145500.0 doi 10.1016/j.cmpb.2021.106272 sideral 124591 ART-2021-124591 eng Alastruey López, Diego Biomechanical evaluation of syndesmotic fixation techniques via finite element analysis: Screw vs. suture button 2021 Access copy available to the general public Unrestricted Background and Objective: Tibiofibular syndesmotic injuries may cause degenerative changes, reduction in ankle function and compromising ankle stability. Different fixation techniques try to restore its functionality. Screw-fixation is the gold-standard. Recently, suture-button fixation has aroused the attention because it allows for physiologic micromotion while maintaining an accurate reduction. The aim of this study is to compare the biomechanical behaviour of both fixation techniques using the finite element method. Methods: A three-dimensional finite element model of the tibiofibular joint was reconstructed simulating the intact ankle and the injured syndesmosis. Then, different methods of syndesmosis fixation were analysed: screws (number of cortices, number of screws and distance between screws) and suture buttons (single, double parallel and double divergent with a sensitivity analysis on the pretension forces) configuration. Ligaments and cartilages were included and simulated as spring elements. Physiological loads during stance phase were simulated. Results: Syndesmosis widening and von Mises stresses were computed. Syndesmosis widening in the injured configuration compromised joint stability (2.06 mm), whereas using a single quadricortical screw (0.18 mm) stiffened the joint. Syndesmosis widening using suture-buttons were closer to syndesmosis widening of the intact ankle configuration (0.97 mm). Von Mises stresses were higher for the titanium screws than for the suture buttons. Conclusions: A detailed biomechanical comparison among different syndesmotic fixation was performed. Suture buttons have advantages with regard to syndesmosis widening in comparison to screw fixation. This fact supports the good long-term clinical results obtained with suture buttons fixation. The proposed methodology could be an efficient tool for preoperative planning. info:eu-repo/grantAgreement/ES/MINECO/DPI2017-84780-C2-1-R info:eu-repo/semantics/openAccess by-nc-nd http://creativecommons.org/licenses/by-nc-nd/3.0/es/ 7.027 2021 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS 20 / 112 = 0.179 2021 Q1 T1 MEDICAL INFORMATICS 6 / 31 = 0.194 2021 Q1 T1 ENGINEERING, BIOMEDICAL 20 / 98 = 0.204 2021 Q1 T1 COMPUTER SCIENCE, THEORY & METHODS 12 / 111 = 0.108 2021 Q1 T1 1.329 2021 Health Informatics 2021 Q1 Computer Science Applications 2021 Q1 9.7 2021 info:eu-repo/semantics/article info:eu-repo/semantics/acceptedVersion Seral, Belén Universidad de Zaragoza (orcid)0000-0002-4502-460X Pérez Ansón, María de los Ángeles Universidad de Zaragoza (orcid)0000-0002-2901-4188 1013 830 Universidad de Zaragoza Dpto. Cirugía Área Traumatología y Ortopedia 5004 605 Universidad de Zaragoza Dpto. Ingeniería Mecánica Área Mec.Med.Cont. y Teor.Est. 208 (2021), 106272 [7 pp.] Comput. methods programs biomed. Computer Methods and Programs in Biomedicine 0169-2607 1151076 http://zaguan.unizar.es/record/117682/files/texto_completo.pdf Postprint 1193691 http://zaguan.unizar.es/record/117682/files/texto_completo.jpg?subformat=icon icon Postprint oai:zaguan.unizar.es:117682 articulos driver 2023-05-18-14:55:20 ARTICLE