Quantitative biomechanical comparison of ankle fracture casting methods
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Alastair Shipman
Abstract
The incidence of ankle fractures is increasing rapidly due to the ageing demographic. In older patients with compromised distal circulation, conservative treatment of fractures may be indicated. High rates of malunion and complications due to skin fragility motivate the design of novel casting systems, but biomechanical stability requirements are poorly defined. This article presents the first quantitative study of ankle cast stability and hypothesises that a newly proposed close contact cast (CCC) system provides similar biomechanical stability to standard casts (SC). Two adult mannequin legs transected at the malleoli, one incorporating an inflatable model of tissue swelling, were stabilised with casts applied by an experienced surgeon. They were cyclically loaded in torsion, measuring applied rotation angle and resulting torque. CCC stiffness was equal to or greater than that of SC in two measures of ankle cast resistance to torsion. The effect of swelling reduction at the ankle site was significantly greater on CCC than on SC. The data support the hypothesis that CCC provides similar biomechanical stability to SC and therefore also the clinical use of CCC. They suggest that more frequent re-application of CCC is likely required to maintain stability following resolution of swelling at the injury site.
Acknowledgments
The authors gratefully acknowledge the support of the NIHR Oxford Biomedical Research Centre, Joint Action and the NIHR Oxford Musculoskeletal Biomedical Research Unit. These funders had no involvement in any aspect of the study.
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©2015 by De Gruyter
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Technically assisted rehabilitation – approaches for the upper extremity
- Special issue articles
- Computational models of upper-limb motion during functional reaching tasks for application in FES-based stroke rehabilitation
- A proposal for patient-tailored supervision of movement performance during end-effector-based robot-assisted rehabilitation of the upper extremities
- An EEG/EOG-based hybrid brain-neural computer interaction (BNCI) system to control an exoskeleton for the paralyzed hand
- A surface EMG test tool to measure proportional prosthetic control
- Research articles
- Adhesion of human mesenchymal stem cells can be controlled by electron beam-microstructured titanium alloy surfaces during osteogenic differentiation
- Bionic approach for the prevention of exit-site infections of percutaneous devices
- Segmented independent component analysis for improved separation of fetal cardiac signals from nonstationary fetal magnetocardiograms
- Fuzzy decision tree to classify complex fractionated atrial electrograms
- Short communications
- A method for stereoscopic strain analysis of the right ventricle by digital image correlation during coronary bypass surgery: short communication
- Quantitative biomechanical comparison of ankle fracture casting methods
