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

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. Methods: Twenty matched pairs of cadaveric feet were randomized to fusion with either a single 5.5-mm cannulated scr...

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Bibliographic Details
Published in:Foot & ankle international 2020-11, Vol.41 (11), p.1427-1431
Main Authors: O’Neil, Joseph T., Abbasi, Pooyan, Parks, Brent G., Miller, Stuart D.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Arthrodesis - methods
Biomechanical Phenomena
Bone Plates
Bone Screws
Cadaver
Female
Humans
Male
Middle Aged
Random Allocation
Talus - surgery
Tarsal Bones - surgery
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Summary: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. 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. 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. Clinical Relevance: This information may be helpful to surgeons in implant selection for this common arthrodesis procedure.
ISSN:1071-1007
1944-7876
DOI:10.1177/1071100720942468