title: A biomechanical comparison of internal fixation techniques for ankle arthrodesis.
abstract: The purpose of the present study was to compare the primary bending stiffness characteristics of 5 different ankle arthrodesis fixation techniques: 3 compression screws, an anterior locking plate, a lateral locking plate, an anterior locking plate with a compression screw, and a lateral locking plate with a compression screw. A total of 25 full-scale anatomic models consisting of fourth-generation composite tibiae and tali were tested using an Instron 4505 Universal Testing System. We hypothesized that the use of a compression screw with a locking plate would add considerable stiffness to the fixation construct compared with the use of a locking plate alone. The data have shown that an anterior or lateral plate with a compression screw provides significantly greater stiffness than both a plate and 3 compression screws used individually. No significant difference was seen between the anterior plate with a compression screw and the lateral plate with a compression screw. No significant differences were found among the use of an anterior plate, a lateral plate, or 3 compression screws. We have concluded that when using a locking plate in an anterior or lateral configuration, the addition of a compression screw will considerably increase the primary bending stiffness of ankle arthrodesis.
authors.affiliation: Franciscan Orthopedic Associates, Federal Way, WA.
authors.forename: Craig
authors.initials: C
authors.lastname: Clifford
authors.affiliation: Postgraduate Year III Resident, Franciscan Health System, Federal Way, WA. Electronic address: scottlewisberg@gmail.com.
authors.forename: Scott
authors.initials: S
authors.lastname: Berg
authors.affiliation: St Cloud Orthopedics, Sartell, MN.
authors.forename: Kevin
authors.initials: K
authors.lastname: McCann
authors.affiliation: Franciscan Foot and Ankle Institute, Federal Way, WA.
authors.forename: Byron
authors.initials: B
authors.lastname: Hutchinson
mesh_terms: D000843:Ankle Joint / Q000503:physiopathology* / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D016268:Internal Fixators; D008953:Models, Anatomic; D016059:Range of Motion, Articular / Q000502:physiology; D016474:Weight-Bearing / Q000502:physiology
keywords: ankle arthrodesis; bone model; compression screw; load cell; locking plate