ArticleThe American journal of sports medicine2023
Additional Plate Fixation of Hinge Fractures After Varisation Distal Femoral Osteotomies Provides Favorable Torsional Stability: A Biomechanical Study.
Article in The American journal of sports medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Complications of osteotomies around the knee.Bulletin of the Hospital for Joint Disease (2013) · 2026Review
- Finite Element Investigation of Protective K-Wire Contribution to Hinge Fracture Prevention in Distal Femoral Osteotomy.Annals of biomedical engineering · 2026Article
- The Closing Wedge Distal Femoral Osteotomy: A Series of 19 Cases for the Management of Genu Valgum and Genu Varum.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- A single lateral hinge screw increased resistance to varus stress after medial closing wedge distal femoral osteotomy in a Sawbones model: A biomechanical analysis.Journal of experimental orthopaedics · 2025Article
- The Type of Lateral Hinge Fracture in Medial Open-Wedge High Tibial Osteotomy Determines Its Stability: A Biomechanical Study.The American journal of sports medicine · 2025Article
- Fixation of Takeuchi Type II/III lateral hinge fractures provides favourable stability of a medial open wedge high tibial osteotomy-A biomechanical study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Ten-year minimal follow-up of lateral opening wedge distal femoral osteotomy for lateral femorotibial osteoarthritis: Good survivorship and high patient satisfaction.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Finite element analysis confirms the optimal apex position in medial opening wedge high tibial osteotomy to avoid lateral hinge fracture.Journal of experimental orthopaedics · 2024Article
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9 authors.
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Abstract
backgroundHinge fractures are considered risk factors for delayed or nonunion of the osteotomy gap in distal femoral osteotomies (DFOs). Limited evidence exists regarding the treatment of hinge fractures after DFO, which could improve stability and thus bone healing. PURPOSE: To (1) examine the effect of hinge fractures on the biomechanical properties of the bone-implant construct, (2) evaluate the biomechanical advantages of an additional fixation of a hinge fracture, and (3) test the biomechanical properties of different types of varisation DFOs. STUDY
designControlled laboratory study.
methodsA total of 32 fresh-frozen human distal femora equally underwent medial closing wedge DFO or lateral opening wedge DFO using a unilateral locking compression plate. The following conditions were serially tested: (1) preserved hinge; (2) hinge fracture along the osteotomy plane; (3) screw fixation of the hinge fracture; and (4) locking T-plate fixation of the hinge fracture. Using a servo-hydraulic materials testing machine, we subjected each construct to 15 cycles of axial compression (400 N; 20 N/s) and internal and external rotational loads (10 N·m; 0.5 N·m/s) to evaluate the stiffness. The axial and torsional hinge displacement was recorded using a 3-dimensional optical measuring system. Repeated-measures 1-way analysis of variance and post hoc Bonferroni correction were used for multiple comparisons. Statistical significance was set at
resultsIndependent from the type of osteotomy, a fractured hinge significantly (
conclusionHinge fractures after medial closing wedge DFO and lateral opening wedge DFO caused decreased bone-implant construct rotational stiffness and increased fracture-site displacement. In contrast, the axial stiffness remained unchanged in the cadaveric model. CLINICAL RELEVANCE: When considering an osteosynthesis of a hinge fracture in a DFO, an additional plate fixation was the construct with the highest stiffness and least displacement, which could restore intact hinge rotational displacement.
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