Ankle Arthrodesis With Anterior Plate Fixation in Patients at High Risk for Nonunion

Abstract

Between January 1, 2011, and January 1, 2017, an orthopaedic foot and ankle surgeon performed tibiotalar arthrodesis on 221 patients. Thirty-two were included in this study. Inclusion criteria included patients with at least one risk factor for nonunion and/or malunion, isolated anterior ankle arthrodesis with plate fixation, patients older than 18, and a minimum of 1-year follow-up. Risk factors were avascular necrosis of the talus, severe segmental bone defect, smoking, inflammatory arthropathy, coronal deformity greater than 15°, diabetes mellitus, septic nonunion, failed ankle arthrodesis, and body mass index greater than 35. Functional outcome questionnaires (Ankle Osteoarthritis Score [AOS] and Foot Function Index [FFI]) were collected at the latest visit or by phone. Twenty-six (26/32, 81.2%) patients included in the study had computed tomography images available for review at an average of 3.2 months after surgery. The rate of successful arthrodesis was 93.8% (30/32) at an average of 78 days. Overall, 14 patients (14/32, 43.8%) developed a postoperative complication, including 1 patient that had a delayed nonunion and 2 patients that proceeded to nonunion. Twenty-three patients (23/32, 71.9%) completed the functional outcome questionnaires at an average of 26.8 months. Mean AOS and FFI scores improved significantly postoperatively ( P < .001). Sagittal tibiotalar and coronal tibiotalar alignment improved significantly in patients with severe preoperative deformity ( P < .001). Tibiotalar arthrodesis with anterior plate fixation in a high-risk cohort results in high union rates and significantly improved functional outcomes. Levels of Evidence: Therapeutic, Level IV: Prospective, comparative trial.

Tibiotalar and Tibiotalocalcaneal Arthrodesis with Paragon28 SilverbackTM Plating System in Patients with Severe Ankle and Hindfoot Deformity

“…The patients included in this study had a mean age of 60.0 years, which is consistent with the data from the literature which show that TT and TTC arthrodesis are mainly performed in the sixth decade of life and are equally distributed between men and women [ 15 , 16 , 24 , 45 ]. Furthermore, our case history confirms secondary (post-traumatic) ankle OA as the main indication for TT arthrodesis [ 17 , 46 , 47 ].…”

Combined Transfibular and Anterior Approaches Increase Union Rate and Decrease Non-Weight-Bearing Periods in Ankle Arthrodesis: Combined Approaches in Ankle Arthrodesis

“…In order to assess the correction of the anterior translation of the talus in the sagittal plane after surgery, sagittal talar migration was used. Sagittal talar migration was measured as the distance between the longitudinal axis of the tibia and the lateral process of the talus on lateral radiographs [15]. Anteroposterior offset and sagittal talar migration were represented as a positive number when the center or the lateral process of the talus was located anterior to the tibial axis.…”

Deep peroneal neuropathy diagnosed by musculoskeletal ultrasound after ankle arthrodesis with an anterior plate: a case report

“…Current studies are favorable for anterior plating as the technique is associated with high union rates with relatively few complications. [4][5][6] We present our case to raise awareness of this rare complication given the increasing popularity of anterior ankle plating.…”