title: Ankle arthrodesis using dowel bone graft and cancellous-bone screws: a mechanical study in cadavers.
abstract: BACKGROUND
  There are numerous techniques for ankle arthrodesis.
  
  
  METHODS
  We studied the stability of an ankle arthrodesis with the use of two cross-screws combined with dowel graft technique in 14 fresh-frozen ankles from amputees. The arthrodesis was performed by a dowel graft technique, in the coronal plane in 7 specimens (group 1) and in the diagonal plane in the remaining 7 (group 2). Allocation into the two groups took place after normalization according to the bone mineral content of the specimens. All ankles were fixed with two 6.5-mm diameter cancellous-bone screws, with the ankle in neutral position. Tibiotalar motion was measured during 5 Nm torque loading in plantar flexion-dorsiflexion, abduction-adduction and eversion-inversion planes of the ankle joint. Two testing sequences were performed and the mean value of both tests in each direction was used for the analysis.
  
  
  RESULTS
  In all 3 planes, the torque applied caused more motion with the dowel graft in the coronal plane (group 1) than with the graft in the diagonal plane (group 2). The differences between the two groups were significant for abduction-adduction and eversion-inversion planes. Statistical analysis of differences between the first and second test showed significantly greater stiffness in group 2 than in group 1 in plantar flexion-dorsiflexion torque.
  
  
  CONCLUSIONS
  The placement of a dowel graft in the diagonal plane in comparison to the coronal plane significantly increased the initial stability of an ankle arthrodesis.
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, Göteborg, Sweden. abbas.karladani@orthop.gu.se
authors.forename: Abbas
authors.initials: A
authors.lastname: Karladani
authors.forename: Georgias
authors.initials: G
authors.lastname: Digas
authors.forename: Lars
authors.initials: L
authors.lastname: Ekström
authors.forename: Janos
authors.initials: J
authors.lastname: Swanpalmer
authors.forename: Jorma
authors.initials: J
authors.lastname: Styf
authors.forename: Tommy
authors.initials: T
authors.lastname: Hansson
mesh_terms: D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D001696:Biomechanical Phenomena; D001863:Bone Screws; D016025:Bone Transplantation; D002102:Cadaver; D006801:Humans