Load to Failure of the Ankle Joint Complex After Fusion of the Subtalar and Talonavicular Joints: A Cadaveric Study.

Recent literature has proposed that restriction of joints in the rearfoot secondary to coalitions may lead to increased risk for severe ankle fracture after trauma. There is a paucity of literature regarding the rigidity of the ankle joint after arthrodesis of the subtalar and talonavicular joints. In this study, load-to-failure testing of cadaveric ankle joints with and without fusion of the subtalar and talonavicular joints was performed to determine if clinically relevant fracture patterns could be reproduced. Of the 3 fixation patterns studied, combined subtalar and talonavicular joint fusion resulted in a measurable increase in joint stiffness; however, this was not statistically significant. Clinical and radiographic examination postloading revealed that all tested ankle joints sustained a dislocation type injury rather than a specific bone fracture pattern. It was determined that a pure low-speed bending and compression model does not produce clinically relevant fracture patterns, and that higher energy mechanisms are required.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Published by Elsevier Inc.)