{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:58:37Z","timestamp":1777615117564,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2019,3,12]],"date-time":"2019-03-12T00:00:00Z","timestamp":1552348800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Novastep"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot &amp; Ankle Specialist"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:p>\n                    Background. Ankle arthrodesis is a procedure utilized in the treatment of end-stage ankle arthritis. Internal fixation with screws is traditionally relied on to achieve union. Although the use of screw fixation alone has produced satisfactory outcomes, nonunion rates can range from 9% to as high as 35%. Adding an additional screw to the traditional 2-screw fixation construct may improve the likelihood of union by adding strength and stiffness; however, this addition may counteract the theoretical fusion enhancement benefit by reducing the joint surface area (SA) available for fusion. Methods. A cadaver study was performed to compare the amount of SA lost from a standard 2-screw (group 1) versus the 3-screw ankle fusion construct (group 2). A total of 10 fresh cadaveric below-knee specimens were used. Cannulated 7.0-mm partially threaded screws were placed across the ankle joint. Each talus was examined to precisely determine joint SA loss following each procedure. Results. The mean total talus SA in group 1 was 1833.71 mm\n                    <jats:sup>2<\/jats:sup>\n                    compared with 2125.76 mm\n                    <jats:sup>2<\/jats:sup>\n                    in group 2. The mean SA lost by the 2-screw construct was 5.91%, versus 9.51% in the 3-screw construct group. The talus SA loss percentage difference between groups reached statistical significance (P = .0220). Conclusion. The addition of a third 7.0-mm screw to a 2-screw ankle fusion construct raised the percentage of joint surface lost from 5.91% to 9.5%. Clinical Relevance. Surgeons may consider using extra-articular plates with 1 or 2 intra-articular screws instead of the traditional 3-screw construct if there is an elevated concern for nonunion.\n                  <\/jats:p>\n                  <jats:p>Levels of Evidence: Level IV: Cadaveric case series<\/jats:p>","DOI":"10.1177\/1938640019832359","type":"journal-article","created":{"date-parts":[[2019,3,13]],"date-time":"2019-03-13T01:43:23Z","timestamp":1552441403000},"page":"50-53","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["A Comparison of Talar Surface Area Occupied by 2- Versus 3-Screw Fixation for Ankle Arthrodesis"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0329-0069","authenticated-orcid":false,"given":"Eric","family":"So","sequence":"first","affiliation":[{"name":"The CORE Institute, Phoenix, Arizona (ES)"},{"name":"Orthopedic Foot and Ankle Center, Westerville, Ohio (RAB, PEB)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberto A.","family":"Brand\u00e3o","sequence":"additional","affiliation":[{"name":"The CORE Institute, Phoenix, Arizona (ES)"},{"name":"Orthopedic Foot and Ankle Center, Westerville, Ohio (RAB, PEB)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3527-4530","authenticated-orcid":false,"given":"Patrick E.","family":"Bull","sequence":"additional","affiliation":[{"name":"The CORE Institute, Phoenix, Arizona (ES)"},{"name":"Orthopedic Foot and Ankle Center, Westerville, Ohio (RAB, PEB)"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,3,12]]},"reference":[{"key":"bibr1-1938640019832359","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-15-00354"},{"key":"bibr2-1938640019832359","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200305000-00026"},{"key":"bibr3-1938640019832359","first-page":"44","volume":"25","author":"Saltzman CL","year":"2005","journal-title":"Iowa Orthop J"},{"key":"bibr4-1938640019832359","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v5.i1.1"},{"key":"bibr5-1938640019832359","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2014.06.002"},{"key":"bibr6-1938640019832359","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-008-0543-6"},{"key":"bibr7-1938640019832359","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200709000-00002"},{"key":"bibr8-1938640019832359","first-page":"56","author":"Maurer RC","year":"1991","journal-title":"Clin Orthop"},{"key":"bibr9-1938640019832359","doi-asserted-by":"publisher","DOI":"10.3109\/17453679608996671"},{"key":"bibr10-1938640019832359","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401500602"},{"key":"bibr11-1938640019832359","first-page":"21","author":"Holt ES","year":"1991","journal-title":"Clin Orthop Relat Res"},{"key":"bibr12-1938640019832359","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000071755.41516.a0"},{"key":"bibr13-1938640019832359","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2010.0492"},{"key":"bibr14-1938640019832359","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2009.0353"},{"key":"bibr15-1938640019832359","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199274070-00012"},{"key":"bibr16-1938640019832359","doi-asserted-by":"publisher","DOI":"10.1177\/1071100713504746"},{"key":"bibr17-1938640019832359","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602700109"},{"key":"bibr18-1938640019832359","unstructured":"Rasband WS. 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