Twenty-three fresh-frozen human specimens were subjected to ankle
arthrodesis and fixation with two cancellous-bone screws. The specimens
were then subjected to four newton-meters of manually applied tibial
torque, plantar flexion-dorsiflexion moment, and medial-lateral bending
moment; relative rotation between the tibia and the talus was recorded for
each mode of testing. A Calandruccio triangular compression device was then
applied to threaded pins penetrating the tibia and talus, the screws were
removed, and the test sequence was repeated. Tibiotalar motions recorded
with both systems of fixation were markedly affected by the quality of the
bone. When less than 2 degrees of total tibiotalar rotation was recorded in
response to four newton-meters of manually applied internal-external tibial
torque, all specimens demonstrated less torsional rotation with the screw
fixation than with the external fixator. The mean rotations produced by
medial-lateral bending moment were equivalent for both systems of fixation.
When torsional rotations with the use of screw fixation were greater than 2
degrees, all specimens demonstrated more torsional rotation with the screws
than with the external fixator, and all but one specimen had more
medial-lateral rotation with the screws than with the fixator. For applied
plantar flexion-dorsiflexion moment, twenty-two of the twenty-three
specimens demonstrated more rotation with the Calandruccio fixator than
with the screws; this was due in part to motion permitted at the hinge
points of the frame itself.