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J Foot Ankle Surg. 2015 Mar-Apr;54(2):188-91. doi: 10.1053/j.jfas.2014.06.002. Epub 2014 Aug 10.

A biomechanical comparison of internal fixation techniques for ankle arthrodesis.

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Franciscan Orthopedic Associates, Federal Way, WA.
Postgraduate Year III Resident, Franciscan Health System, Federal Way, WA. Electronic address:
St Cloud Orthopedics, Sartell, MN.
Franciscan Foot and Ankle Institute, Federal Way, WA.


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.


ankle arthrodesis; bone model; compression screw; load cell; locking plate

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