Biomechanical evaluation of primary stiffness of tibiotalar arthrodesis with an intramedullary compression nail and four other fixation devices

摘要

To determine the stiffness and fusion-site compression obtained by fixing a tibiotalar arthrodesis using an intramedullary compression nail and compare these results with results from four other fixation techniques. Fifteen Sawbones~R (Sawbones Europe, Malmo, Sweden) third-generation composite tibiae and 15 anatomically correct synthetic models of the talus were obtained. Five fixation methods were tested: a compressed external fixator, an uncompressed interlocking nail, a compressed interlocking nail, three screws inserted as described by Thermann et al., and three screws inserted as described by Smith. Each of the techniques was tested on three specimens prepared by milling the talar dome and distal tibia to produce plane-parallel surfaces. Each arthrodesis was performed with the constructs in neutral flexion, 5deg of external rotation, and 0deg in the frontal plane.