Arthrodesis of the Ankle Joint

Abstract

The technique of the transfibular approach for arthrodesis of the ankle joint is described. The results of this operation in a series of thirty cases shows that the procedure is reliable if the technique is carried out faithfully. The two cases in which a first operation failed can both be explained by errors of technique or after-treatment.

Tibio-talocalcaneal arthrodesis as a primary proce-dure using a retrograde intramedullary nail

“…The fusion rate has improved over the past decade due to refined surgical methods (Adams 1948, Charnley 1951, Adam and Ranawat 1976, Lauge-Pedersen et al 1998a, Hanson and Cracchiolo 2002. Most reports review cases with posttraumatic arthrosis, and some include various diagnoses (Buratti et al 1994, Kile et al 1994, Chou et al 2000, Goebel et al 2003.…”

“…The rate of pseudarthrosis and other complications when external fixation or compression screws were used has shown great variation. Adams (1948) described a case of pseudarthrosis after attempted fusion, which healed after reoperation with a flanged, retrograde intramedullary nail. This method was later adopted by others (Carrier and Harris 1991, Stone and Helal 1991, Madezo et al 1998, Fujimori et al 1999, Chou et al 2000, Medicino et al 2004) who (taken together) reported approximately 50 RA cases treated with a retrograde intramedullary nail.…”

Screw fixation for ankle arthrodeses

“…Since Albert [29] first described arthrodeses of the ankle, more than forty different methods have been described [2–5, 7–14, 30]. Charnley [30] was the first to introduce the biomechanically advantageous principle of compression.…”

“…Over 50 methods for ankle arthrodesis have been described in the last decade alone, including stabilization with external fixators, a paediatric blade plate, and intramedullary rods and screws. Two basic techniques predominate, an external fixator or internal fixation with lag screws [2–14]. Clinical and biomechanical studies have however shown that the latter technique has superior fusion rates and lower complication rates [14–23].…”

Die „Beckenkammspan-Interpositionsarthrodese“ des oberen Sprunggelenks

“…Various techniques have been described [1,2,7,8,10,12,13,15,19,20]. Biomechanical investigations have shown a greater stability of internal fixation with screws than with external fixation [6,14,18].…”