{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T17:40:46Z","timestamp":1763746846872,"version":"3.38.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2009,12,1]],"date-time":"2009-12-01T00:00:00Z","timestamp":1259625600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:p> Background: Retrograde intramedullary nailing is an established technique for tibiotalocalcaneal arthrodesis (TTCA). In poor bone stock (osteoporosis, neuroarthropathy), device fixation in the hindfoot remains a problem. Fixed-angle spiral-blade fixation of the nail in the calcaneus could be useful. Materials and Methods: In seven matched pairs of human below-knee specimens, bone mineral density (BMD) was determined, and TTCA was performed with an intramedullary nail (Synthes Hindfoot Arthrodesis Nail HAN Expert Nailing System), using a conventional screw plus a fixed-angle spiral blade versus a conventional screw plus a fixed-angle screw, in the calcaneus. The constructs were subjected to quasi-static loading (dorsiflexion\/plantarflexion, varus\/valgus, rotation) and to cyclic loading to failure. Parameters studied were construct neutral zone (NZ) and range of motion (ROM), and number of cycles to failure. Results: With dorsiflexion\/plantarflexion loading, the screw-plus-spiral-blade constructs had a significantly smaller ROM in the quasi-static test ( p = 0.028) and early in the cyclic test ( p = 0.02); differences in the other parameters were not significant. There was a significant correlation between BMD and cycles to failure for the two-screw constructs ( r = 0.94; p = 0.002) and for the screw-plus-spiral-blade constructs ( r = 0.86; p = 0.014). Conclusion: In TTCA with a HAN Expert Nailing System, the use of a calcaneal spiral blade can further reduce motion within the construct. This may be especially useful in poor bone stock. Clinical Relevance: Results obtained in this study could be used to guide the operating surgeon's TTCA strategy. <\/jats:p>","DOI":"10.3113\/fai.2009.1212","type":"journal-article","created":{"date-parts":[[2009,12,11]],"date-time":"2009-12-11T18:23:17Z","timestamp":1260555797000},"page":"1212-1218","source":"Crossref","is-referenced-by-count":26,"title":["Comparison of Calcaneal Fixation of a Retrograde Intramedullary Nail with a Fixed-Angle Spiral Blade Versus a Fixed-Angle Screw"],"prefix":"10.1177","volume":"30","author":[{"given":"Kajetan","family":"Klos","sequence":"first","affiliation":[{"name":"Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boyko","family":"Gueorguiev","sequence":"additional","affiliation":[{"name":"Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karsten","family":"Schwieger","sequence":"additional","affiliation":[{"name":"Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosemarie","family":"Fr\u00f6ber","sequence":"additional","affiliation":[{"name":"Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Brodt","sequence":"additional","affiliation":[{"name":"Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gunther O.","family":"Hofmann","sequence":"additional","affiliation":[{"name":"Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Windolf","sequence":"additional","affiliation":[{"name":"Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"M\u00fcckley","sequence":"additional","affiliation":[{"name":"Davos, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,12,1]]},"reference":[{"key":"bibr1-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1097\/01.bot.0000184142.90448.e3"},{"key":"bibr2-FAI.2009.1212","first-page":"10","volume":"268","author":"Carrier DA","year":"1991","journal-title":"Clin Orthop."},{"key":"bibr3-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200312000-00022"},{"key":"bibr4-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2005.12.001"},{"key":"bibr5-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1007\/s00113-003-0626-5"},{"key":"bibr6-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1007\/s00064-005-1137-7"},{"key":"bibr7-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1177\/107110070502601004"},{"key":"bibr8-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200103000-00008"},{"key":"bibr9-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1177\/107110079401501208"},{"key":"bibr10-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1177\/107110070102200908"},{"key":"bibr11-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1177\/107110070602701221"},{"key":"bibr12-FAI.2009.1212","first-page":"531","volume":"31","author":"Millett PJ","year":"2002","journal-title":"Am J Orthop."},{"key":"bibr13-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1046\/j.1460-9584.1998.00077.x"},{"key":"bibr14-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198062050-00012"},{"key":"bibr15-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0224"},{"key":"bibr16-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.G.00010"},{"key":"bibr17-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2007.0605"},{"key":"bibr18-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-005-0410-1"},{"key":"bibr19-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2008.0581"},{"key":"bibr20-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2006.0804"},{"key":"bibr21-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-199274070-00011"},{"key":"bibr22-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.3113\/FAI.2008.0936"},{"key":"bibr23-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198567040-00008"},{"key":"bibr24-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1007\/s005860050045"},{"key":"bibr25-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2008.07.004"},{"key":"bibr26-FAI.2009.1212","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2008.09.005"}],"container-title":["Foot &amp; 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