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Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Bellinzona, Switzerland
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Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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-union. In this light, evidence-based data could guide surgeons in understanding the biomechanical properties of the different options to choose the most suitable implant and provide the best fixation strategy. Figure 1 Classic crossed screw fixation
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University Hospital for Orthopaedics and Trauma Surgery Pius-Hospital, Medical Campus University of Oldenburg, Oldenburg, Germany
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.2) Joint fixation Plate + screw 285 277 (97.2) 8 (2.8) Crossplate compression screw 16 14 (87.5) 2 (12.5) Crossed screws 415 369 (88.9) 46 (11.1) Plate 199 186 (93.5) 13 (6.5) Other* 19 16
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operatively. 2 The goals of surgery are reduction and maintenance of the structures in their correct position so that the ligaments can heal properly. 12 This is achieved by syndesmotic screw fixation, suture-button dynamic fixation or repair of the
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first TMT joint are described in the literature: screw fixation with different screw positions, two crossed screws through the first TMT joint in most of the studies, staple fixation, external fixation, as well as dorso-medial, medial and plantar locking
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operative procedures for those patients. 19 Similar ankle fusion rates (14 out of 17) were previously reported in another study, where the author used crossed screws for fixation; however, three amputations were required. 20 More recently, 27
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complications, such as wound infection, sural nerve injury and failure of the implants. 3 , 13 - 15 Open reduction and internal fixation ORIF with plate and screws (locking or non-locking plates) via an extensile lateral L-shaped approach has been
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maintaining bony contact. Fixation can include crossed lag screws or a lag screw with a dorsal plate ( Fig. 5 ). Biomechanical testing has shown that a lag screw with a dorsal plate offers the most stable construct, although at the expense of increased cost of
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previously said, an association with a Deltoid ligament lesion is highly predictive of an unstable injury. 45 The surgical options vary between a rigid fixation, with screws, and a dynamic fixation with suture-button-like materials. Screws have been the
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exist for ankle arthrodesis: a) AP and lateral views of an arthrodesis of the left ankle with external fixation using the Charnley frame; b) AP and lateral views of an arthrodesis of the right ankle with crossed screws internal fixation. Total
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locking screws with Fixion IM could have contributed to a less stable fixation; however, both studies failed to report whether or not implant failure was observed. Subgroup analysis of implant failure based on studies whose nail diameter was 10 mm or lower
