Ankle fusion by plating through an anterior approach followed by posterolateral approach: a three-dimensional finite element analysis / 中国组织工程研究

ABSTRACT

BACKGROUND: End-stage ankle arthritis will cause sustained pain of the ankle joint, which severely affects patients' life quality. Surgical treatment is necessary when conservative method is invalid, and ankle fusion is the gold standard for end-stage ankle arthritis. OBJECTIVE: To establish a three-dimensional finite element model of ankle fusion by anterior plating, followed by a posterolateral screw, thus analyzing the biomechanical changes.METHODS: CT data of normal people were imported into the relevant software to establish a three-dimensional finite element model of the ankle, and simulated ankle fusion by software processing. Subsequently, the models of ankle fusion by anterior plating system and combined posterolateral screws were established, and a three-dimensional finite element analysis was performed under neutral position, dorsiflexion, intorsion and extorsion. RESULTS AND CONCLUSION: The maximum displacement and stress under dorsiflexion, intorsion and extorsion in the combined model were significantly decreased compared with the simple model, and the values under neutral position showed no significant changes in the two methods. Additionally, the stress distribution did not differ significantly between two models. To conclude, plates combined with screws significantly improve the stability and safety of fusion.