Thickness of Simple Calcaneal Tuberosity Avulsion Fractures Influences the Optimal Fixation Method Employed

Thickness of Simple Calcaneal Tuberosity Avulsion Fractures Influences the Optimal Fixation Method Employed

Chunliang (Chunliang) Wang, MD, TAIWAN Chia-Hung Hung, MD, TAIWAN Chung-Hsun Chang, MD, PhD, TAIWAN

Fu Jen Catholic University Hospital, New Taipei City, Taiwan, TAIWAN


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Anatomic Location

Treatment / Technique

Anatomic Structure

Diagnosis / Condition

Sports Medicine


Summary: Fragment thickness affects the pullout strength of headless screw fixation more than suture anchor fixation.


Aims
This study aimed to establish the optimal fixation methods for calcaneal tuberosity avulsion fractures with different fragment thicknesses in a porcine model.

Methods

A total of 36 porcine calcanea were sawed to create simple avulsion fractures with three different fragment thicknesses (5, 10, and 15 mm). They were randomly fixed with either two suture anchors or one headless screw. Load-to-failure and cyclic loading tension tests were performed for the biomechanical analysis.

Results

This biomechanical study predicts that headless screw fixation is a better option if fragment thickness is over 15 mm in terms of the comparable peak failure load to suture anchor fixation (headless screw: 432.55 N (SD 62.25); suture anchor: 446.58 N (SD 84.97)), and less fracture fragment displacement after cyclic loading (headless screw: 3.94 N (SD 1.76); suture anchor: 8.68 N (SD 1.84)). Given that the fragment thickness is less than 10 mm, suture anchor fixation is a safer option.

Conclusion

Fracture fragment thickness helps in making the decision of either using headless screw or suture anchor fixation in treating calcaneal tuberosity avulsion fracture, based on the regression models of our study.