Objective: To assess the optimal configuration of double-screw fixation for subtalar arthrodesis using finite element analysis.

Methods: Three-dimensional finite element double-screw models of subtalar arthrodesis were reconstructed using Mimics 13.0, Geomagic 10.0 and solid works software based on the 3-D images of the volunteer's right foot. The external and internal rotation torques of 4 N·m were applied, and the micromotion at the bone-to-bone interface were measured to evaluate the initial stability of subtalar arthrodesis.

Results: A neck screw plus an anterolateral dome screw was the most stable model. The peak micromotion at the fusion site of this fixation configuration were 41.67mnplus;0.49 and 42.64mnplus;0.75 µm in response to the respectively. A neck screw plus a posteromedial dome screw was the least stable model, with peak micromotion at the bone-to-bone interface of 61.76mnplus;1.00 and 62.32mnplus;0.90 µm, respectively.

Conclusion: A neck screw plus an anterolateral dome screw is the best fixation configuration while a neck screw plus a posteromedial screw provides the least stability of subtalar arthrodesis. Three-dimensional finite element models allow effective preoperative planning of the screw number and placement.

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