Original ResearchA Biomechanical Comparison of Internal Fixation Techniques for Ankle Arthrodesis
Section snippets
Materials and Methods
Testing was performed on full-scale anatomic models consisting of fourth-generation composite tibiae and tali (Pacific Research Laboratories, Vashon WA). The models were prepared for arthrodesis with planar resection of the tibial and talar articular surfaces to a maximum depth of 3 mm. The medial malleolar articular surface was also resected to a maximum depth of 1 mm, with a planar cut at a 90° angle to the prepared tibial surface. All specimens were placed in neutral anatomic alignment
Results
A total of 25 fourth-generation saw bones were tested, 5 each used for each of the 5 different fixation constructs. With dorsiflexion loading, the greatest stiffness was provided by the ALP-S (60.76 ± 12.63 N/mm), which was significantly stiffer than all other fixation methods (p < .001), and provided a bending stiffness 71% greater than the anterior plate alone (p < .001). The addition of a compression screw resulted in a significant increase in bending stiffness (p < .001) for the anterior
Discussion
The results of the present study highlight several important findings. The initial hypothesis was supported by the data showing that a compression screw could add considerable stiffness to a locking plate fixation technique for ankle arthrodesis in certain cases. The addition of a compression screw added significant stiffness to arthrodesis constructs in which the plate was on the compression side of loading (i.e., the anterior plate under dorsiflexion and the lateral plate under eversion).
Acknowledgments
We thank Tuesday Kuykendall for her assistance with the Instron testing system and the Materials Science and Engineering Department, University of Washington, Seattle, WA.
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Financial Disclosure: The hardware used was donated by Tornier, Inc., and research funding was provided by the International Foot & Ankle Foundation for Education and Research.
Conflict of Interest: All of the authors are affiliated with the International Foot & Ankle Foundation for Education and Research.