• Jessica E Goetz, Chamnanni Rungprai, M James Rudert, Lucian C Warth, and Phinit Phisitkul.
• Department of Orthopaedics and Rehabilitation, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Biomedical Engineering, University of Iowa, 5601 Seamans Center, Iowa City, IA 52242, USA. Electronic address: jessica-goetz@uiowa.edu.
• Foot Ankle Surg. 2019 Oct 1; 25 (5): 594-600.

BackgroundThe purpose of this study was to quantify the effects of rigid syndesmotic fixation on functional talar position and cartilage contact mechanics.MethodsTwelve below-knee cadaveric specimens with an intact distal syndesmosis were mechanically loaded in four flexion positions (20° plantar flexion, 10° plantar flexion, neutral, 10° dorsiflexion) with zero, one, or two 3.5-mm syndesmotic screws. Rigid clusters of reflective markers were used to track bony movement and ankle-specific pressure sensors were used to measure talar dome and medial/lateral gutter contact mechanics.ResultsScrew fixation caused negligible anterior and inferior shifts of the talus within the mortise. Relative to no fixation, mean peak contact pressure decreased by 6%-32% on the talar dome and increased 2.4- to 6.6-fold in the medial and lateral gutters, respectively, depending on ankle position and number of screws.ConclusionsTwo-way ANOVA indicated syndesmotic screw fixation significantly increased contact pressure in the medial/lateral gutters and decreased talar dome contact pressure while minimally altering talar position.Copyright © 2018 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

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