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Ankle arthrodesis: a comparative clinical and biomechanical evaluation
Clinical Orthopaedics and Related Research
|September 1, 1980
Summary
Ankle fusion (arthrodesis) is challenging with deformities. A new dynamic compression T-plate offers superior stability compared to older methods, improving ankle fusion success rates.
Area of Science:
- Orthopedic Surgery
- Biomechanics
- Surgical Innovation
Background:
- Ankle arthrodesis presents challenges, particularly with concurrent bony deformity or soft tissue abnormalities.
- Previous methods like Charnley-type compression and R.A.F. fusion showed high pseudarthrosis rates (30%) in complex cases.
Observation:
- Biomechanical evaluation compared Charnley-type compression, R.A.F. fusion, and a novel dynamic compression T-plate.
- Charnley apparatus stability depended on wingnut tension but lacked resistance to rotatory forces.
Findings:
- The dynamic compression T-plate demonstrated excellent stability against rotatory and flexion-extension forces.
- The T-plate achieved approximately 25 pounds/inch of compression across the ankle fusion site.
Implications:
- The T-plate represents a significant advancement for ankle arthrodesis, especially in complex cases.
- Intraoperative radiography is crucial for confirming optimal ankle alignment during fusion procedures.