Staple-Plate Plus Screw vs Screw Alone in Talonavicular Arthrodesis: A Cadaveric Biomechanical Study.

MedStar author(s):
Citation: Foot & Ankle International. 41(11):1427-1431, 2020 Nov.PMID: 32781849Institution: MedStar Union Memorial HospitalDepartment: Curtis National Hand Center | Orthopaedic SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Arthrodesis/mt [Methods] | *Bone Plates | *Bone Screws | *Talus/su [Surgery] | *Tarsal Bones/su [Surgery] | Aged | Aged, 80 and over | Biomechanical Phenomena | Cadaver | Female | Humans | Male | Middle Aged | Random AllocationYear: 2020ISSN:
  • 1071-1007
Name of journal: Foot & ankle internationalAbstract: BACKGROUND: This study evaluated whether the addition of a nitinol staple-plate to a single cannulated screw increased the mechanical stability for a talonavicular fixation construct.CLINICAL RELEVANCE: This information may be helpful to surgeons in implant selection for this common arthrodesis procedure.CONCLUSION: We found a significant increase in stability of the talonavicular joint when a nitinol staple-plate construct was placed to augment a single cannulated screw for the purpose of a talonavicular fusion.METHODS: Twenty matched pairs of cadaveric feet were randomized to fusion with either a single 5.5-mm cannulated screw or a screw and a plate with 2 screws and a slot with an 18-mm nitinol staple. After in situ fusion procedure, the talonavicular joint complex was dissected free and the ends were embedded in epoxy. The specimens were then cyclically loaded on a servohydraulic load frame (1000 cycles at 20 N, increasing at intervals of 20 N until failure), half of them for cantilever bending and the other half for torsion.RESULTS: In the bending arm of the study, the staple-plate group showed significantly higher stiffness, failure load, and cycles to failure. In the torsion arm of the study, the staple-plate group also had higher cycles to failure, stiffness in external rotation, and torque to failure. No significant difference was noted in stiffness in internal rotation.All authors: Abbasi P, Miller SD, O'Neil JT, Parks BGOriginally published: Foot & Ankle International. :1071100720942468, 2020 Aug 12Fiscal year: FY2021Digital Object Identifier: Date added to catalog: 2020-09-02
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Journal Article MedStar Authors Catalog Article 32781849 Available 32781849

BACKGROUND: This study evaluated whether the addition of a nitinol staple-plate to a single cannulated screw increased the mechanical stability for a talonavicular fixation construct.

CLINICAL RELEVANCE: This information may be helpful to surgeons in implant selection for this common arthrodesis procedure.

CONCLUSION: We found a significant increase in stability of the talonavicular joint when a nitinol staple-plate construct was placed to augment a single cannulated screw for the purpose of a talonavicular fusion.

METHODS: Twenty matched pairs of cadaveric feet were randomized to fusion with either a single 5.5-mm cannulated screw or a screw and a plate with 2 screws and a slot with an 18-mm nitinol staple. After in situ fusion procedure, the talonavicular joint complex was dissected free and the ends were embedded in epoxy. The specimens were then cyclically loaded on a servohydraulic load frame (1000 cycles at 20 N, increasing at intervals of 20 N until failure), half of them for cantilever bending and the other half for torsion.

RESULTS: In the bending arm of the study, the staple-plate group showed significantly higher stiffness, failure load, and cycles to failure. In the torsion arm of the study, the staple-plate group also had higher cycles to failure, stiffness in external rotation, and torque to failure. No significant difference was noted in stiffness in internal rotation.

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