title: Comparison of Ankle Fusion Rates With and Without Anterior Plate Augmentation.
abstract: BACKGROUND
  The optimal fixation construct for tibiotalar arthrodesis continues to be debated. While biomechanical data and clinical series support anterior plate augmentation, comparative studies assessing its use are sparse. The purpose of this study was to compare the rates of successful tibiotalar arthrodesis with and without anterior plate augmentation of a compression screw construct.
  
  
  METHODS
  We studied 64 patients (65 ankles) undergoing tibiotalar arthrodesis done by a single surgeon over a 10-year period (2006-2016) with anterior plate augmentation beginning in 2010. Twenty-six ankles had a construct using compression screws only and 39 ankles had anterior plate augmentation of a compression screw construct. We reviewed clinical notes, operative reports, and postoperative radiographs to evaluate for union, incidence of revision, and postoperative complications.
  
  
  RESULTS
  The nonunion rate in the compression screw (CS) cohort was 15.4% and 7.7% in the anterior plate augmentation (AP) cohort ( P = .33). The revision rate was 7.7% in the CS group and 2.6% in the AP cohort ( P = .34). The use of autograft harvested through a separate incision was 19.2% and 17.9% in the CS and AP cohorts, respectively. There were 2 deep postoperative infections in the AP group and none in the patients with CS only ( P = .24). There were no superficial wound complications in either group.
  
  
  CONCLUSIONS
  Anterior plate augmentation was a viable fixation strategy in tibiotalar arthrodesis. In a trend toward an improved rate of fusion and decreased revision rate in the anterior plate augmentation cohort.
  
  
  METHODS
  Level III, retrospective comparative series.
authors.affiliation: 1 Department of Orthopaedic Surgery, Vanderbilt University, Nashville, TN, USA.
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Mitchell
authors.affiliation: 1 Department of Orthopaedic Surgery, Vanderbilt University, Nashville, TN, USA.
authors.forename: Diana G
authors.initials: DG
authors.lastname: Douleh
authors.affiliation: 2 Elite Sports Medicine and Orthopedics, Nashville, TN, USA.
authors.forename: A Brian
authors.initials: AB
authors.lastname: Thomson
mesh_terms: D000842:Ankle / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D001860:Bone Plates; D001863:Bone Screws; D006801:Humans; D011859:Radiography; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000379:methods*
keywords: ankle arthrodesis; anterior plating