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Assessment of the lower limb biomechanics in patients after tibiofibular syndesmosis injury treatment

Klepacki Krzysztof, Kowal Igor, Konieczny Grzegorz, Tomczyk Łukasz, Ciszewski Mariusz, Reichert Paweł, Morasiewicz Piotr

Acta of Bioengineering and Biomechanics

2021

Vol. 23, no. 4

183--190

Purpose: There is no consensus as to the number of bone cortices engaged in tibiofibular syndesmosis treatment. The purpose of our study was to assess the weight distribution on the lower limbs after tricortical or quadricortical syndesmosis fixation and different timing of screw removal. Methods: A total of 55 patients who underwent treatment for acute tibiofibular syndesmosis injury were analyzed in this study. The Zebris pedobarographic platform was used to measure the distribution of body weight on the lower limbs. The study population was stratified by the time to syndesmotic screw removal (8–15 weeks versus 16–22 weeks) and the number of bone cortices involved in fixation (three [tricortical fixation] versus four [quadricortical fixation]). Results: The weight distribution on the operated and healthy limbs in patients with tricortical syndesmosis fixation was asymmetrical, with the mean load on the operated and healthy limbs of 48.38% and 51.62%, respectively. The patients who underwent quadricortical syndesmosis fixation exhibited a symmetrical distribution of weight on the operated and healthy limb. There was a symmetrical distribution of the load of body weight on the operated and healthy limbs both in the group with different times to syndesmotic screw removal. Conclusion: Tricortical syndesmosis fixation is associated with an asymmetrical weight distribution on the operated and healthy limbs. In treating tibiofibular syndesmosis injuries, based on our pedobarographic research, quadricortical syndesmosis fixation and leaving the syndesmotic screw in place for up to 15 weeks, seems more beneficial to the patient.

Assessment of body balance of patients treated with the Ilizarov method for tibial nonunion

Pajchert-Kozłowska Andżelika, Pawik Łukasz, Szelerski Łukasz, Żarek Sławomir, Górski Radosław, Pawik Malwina, Fink-Lwow Felicja, Morasiewicz Piotr

Acta of Bioengineering and Biomechanics

2020

Vol. 22, no. 3

131--137

Purpose: The biomechanics of the musculoskeletal system in patients after tibial nonunion treatment using the Ilizarov method have not yet been fully explored. From the orthopaedic and patient point of view, after the treatment, an assessment should be carried out of the biomechanics of the musculoskeletal system. The aim of this study was to assess the body balance of patients treated with the Ilizarov method for tibial nonunion. Methods: The research group included 24 individuals with a mean age of 55 years, who were treated for aseptic tibial nonunion with the Ilizarov method. The control group was matched to the study group in terms of gender and age, and consisted of 32 subjects with a mean age of 50.5 years and no significant medical history. This study evaluated the balance of patients with the use of pedobarography. Results: In the control group, a statistically significantly shorter path of centre of gravity was observed. There were no statistical differences between the study and control groups for the field area of the centre of gravity. There were no statistical differences between the study and control groups for the minor axis length or major axis length of the centre of gravity. There was a relationship between the centre of pressure path length and the age of the participants in both the control group and the study group. Conclusions: Treatment of patients with tibial nonunion with the Ilizarov fixator achieves similar balance to healthy volunteers. In the pedobarographic evaluation, patients treated for tibial nonunion using the Ilizarov method had similar statics of the musculoskeletal system to healthy volunteers.