A CADAVER BIOMECHANICAL COMPARISON OF THE PLATE CONSTRUCT FOR OPEN LAPIDUS FUSION VERSUS PERCUTANEOUS LAPIDUS FUSION USING SUBCHONDRAL FIXATION
Bibliographic record
Abstract
Introduction: Tarsometatarsal (TMT) fusions traditionally use bridge plates or compression screws through open incisions to correct deformity and achieve bone healing. A new percutaneous technique can remove cartilage, preserve the subchondral bone and transfix the fusion site. Intraosseus, headless, chamfered, full-thread, non-variable pitch screws are used to transfix all available bone. This study compared the biomechanical properties of the plate construct versus the percutaneous construct. Method: TMT joints of six cadavers (12 limbs) were stabilized with a locking plate and 3.5 mm compression screw on one limb, and with a percutaneous Lapidus construct on the matched limb. An extensometer was placed on the plantar side of the TMT. The first metatarsal was point loaded cyclically from 9 to 90 N at 60 mm from the TMT joint at 3 Hz. Testing was stopped if the extensometer reached 7 mm of plantar gap, or when 250,000 cycles were reached. Specimens were then statically loaded to failure. Results: Percutaneous screw specimens reached more cycles to failure at 226,000 ± 58,000 versus 30,000 ± 52,000 for the open plate construct (p<.001). Plantar gap was higher in the open plate construct at all cycle counts from 10 to 10,000 cycles (>4 mm) versus the percutaneous group (<1 mm). Maximum load was higher in the percutaneous group (343.3 ± 92.8 N versus 247.3 ± 28.3 N) (p<.05). Stiffness of the percutaneous group was higher (40.9 ± 13.4 N/mm versus 16.0 ± 5.3 N/mm) (p<.01). No differences were found in bone quality testing. A Cox proportional hazard model identified the mode of fixation as the only significant covariant (p<.05) in predicting cycles to failure. Conclusion: The percutaneous subchondral fixation fusion construct with full-thread, non-variable pitch, intraosseous screws create a stiffer and stronger fixation construct than dorsal plates and cross-screws.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".