title: Anterior plate supplementation increases ankle arthrodesis construct rigidity.
abstract: BACKGROUND
  The success of ankle arthrodesis for the treatment of post-traumatic ankle arthritis depends on achieving and maintaining rigid fixation of the prepared tibiotalar interface. The purpose of this study was to examine the biomechanical effect of anterior plate supplementation of a popular three-screw fusion construct.
  
  
  METHODS
  Six fresh-frozen cadaver ankles were prepared and instrumented with three partially threaded screws compressing the tibiotalar interface. Testing was done with and without supplementary anterior plate fixation under three different decoupled loading conditions: plantarflexion/dorsiflexion, inversion/eversion, and rotation. Motion at the tibiotalar interface was recorded.
  
  
  RESULTS
  Anterior plating increased construct stiffness by a factor of 3.5, 1.9, and 1.4 for the sagittal, coronal, and torsion modes, respectively. Less motion occurred at the tibiotalar interface in all to the three different loading conditions (p = 0.031) with plate supplementation.
  
  
  CONCLUSIONS
  Compared to screws alone, anterior plate supplementation increases construct rigidity and decreases micromotion at the ankle fusion interface.
authors.affiliation: University of Nebraska Medical Center, Orthopaedics, Nebraska Medical Center, Omaha, NE, USA. ivantarkin@cs.com
authors.forename: Ivan S
authors.initials: IS
authors.lastname: Tarkin
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Mormino
authors.forename: Michael P
authors.initials: MP
authors.lastname: Clare
authors.forename: Hani
authors.initials: H
authors.lastname: Haider
authors.forename: Arthur K
authors.initials: AK
authors.lastname: Walling
authors.forename: Roy W
authors.initials: RW
authors.lastname: Sanders
mesh_terms: D000843:Ankle Joint / Q000502:physiology / Q000601:surgery*; D001168:Arthritis / Q000601:surgery; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D001696:Biomechanical Phenomena; D001860:Bone Plates; D001863:Bone Screws; D002102:Cadaver; D006801:Humans; D009038:Motion