Long-Term Results After Ankle Arthrodesis: Clinical, Radiological, Gait Analytical Aspects

Trouillier, Hans; Hansel, Leandro Augusto; Schaff, P.; Rosemeyer, B.; Refior, H. J.

doi:10.1177/107110070202301202

Cited by 27 publications

(13 citation statements)

References 26 publications

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“…Obwohl in den letzten Jahren ermutigende kurz-und mittelfristige Ergebnisse implantierter Prothesen des oberen Sprunggelenks (OSG) publiziert worden sind [3,6,13,17,18,24], bleibt die OSG-Arthrodese bei jungen und aktiven Patienten mit hohen Belastungsansprüchen, bei Patienten mit rheumatischen Erkrankungen und vor allem bei Patienten mit groben Fehlstellungen im Sprunggelenk die Therapie der Wahl [5,8,10,23,25,26].…”

Section: Vorbemerkungenunclassified

Die Arthrodese des oberen Sprunggelenks über den sog. transfibularen Zugang

Fluckiger¹,

Weber

2005

Orthop Traumatol

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20 arthrodeses in 19 patients were followed up for an average of 39 months (12-69 months). All arthrodeses were fused. In one patient a fibular pseudarthrosis was encountered. All arthrodeses healed in a correct position but one that consolidated with a pes equinus of 3 degrees . The average AOFAS (American Orthopedic Foot and Ankle Society) hindfoot score reached 78.5 points (40-86 points). A marked reduction of symptoms and satisfactory function were reported postoperatively by all patients. All would be willing to undergo surgery again.

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Section: Vorbemerkungenunclassified

Die Arthrodese des oberen Sprunggelenks über den sog. transfibularen Zugang

Fluckiger¹,

Weber

2005

Orthop Traumatol

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“…Damit werden unabhängig von den möglichen Osteosynthesetechniken gute kurzund mittelfristige Resultate mit Fusionsraten > 90% erzielt [8,11,15,22,25,27]. Bei langfristigen Kontrolluntersuchungen nach > 10 Jahren [3,7,23,28] wird allerdings übereinstimmend eine hohe Inzidenz von sog. Anschlussarthrosen des subtalaren Gelenks beobachtet.…”

Section: Vorbemerkungenunclassified

“…Good short-and mid-term results exceeding a 90% incidence of fusion can be expected independent of the technique used for internal fixation [8,11,15,22,25,27]. Results after 10 years [3,7,23,28], however, all show a high incidence of osteoarthritis of the subtalar joint. The causes of this arthritis have not been sufficiently investigated.…”

Section: Introductory Remarksmentioning

confidence: 97%

Die tibiotalokalkaneare Arthrodese mit dem retrograd eingebrachten distalen Femurnagel (DFN)

Grass

2005

Orthop Traumatol

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Between February 1, 2002 and September 1, 2003 this technique was performed on 18 feet in 17 patients (three women, 14 men, average age 53 years [38.9-73.7 years]). Average duration of follow-up: 1.2 years (0.6-2.1 years). The goal of surgery was reached in all patients. Subjective assessment: 14 times good, three times satisfactory. Four complications: one loss of nail purchase, one dislocation of locking screw, one breakage of locking bolt, one prolonged bone healing.

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“…But one of the most common and sometimes the only possible method of treating patients with posttraumatic ankle joint arthrosis of grades III-IV is arthrodesis, which preserves support ability and arrests a pain syndrome [14,15]. Arthrodesis with the application of state-of-the-art fixators and technologies enabled many patients to maintain their usual life style: to ride a bicycle, drive a car, go in for sports, and so on, though previously it was considered impossible [16][17][18][19][20].…”

mentioning

confidence: 99%

“…Various kinds of arthrodesis and implants have their advantages and drawbacks [19,[21][22][23][24]. Wires, used as fixators in arthrodesis of ankle joints do not provide compression in the zone of the resected joint surfaces and must be applied with a supplementary immobilization by a plaster bandage.…”

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confidence: 99%

The Concept of Modern Ankle Joint Arthrodesis in Posttraumatic Crusarthrosis, Grade III–IV

Gorbatov¹,

Горін²,

Павлов³

2016

Sovrem Tehnol Med

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The aim of the investigation was to work out a concept of modern arthrodesis of the ankle joint in posttraumatic crusarthrosis, grade III-IV, using innovative fixing implants.Materials and Methods. The results of treating 53 patients covering the period from 1 to 15 years after 56 operations of arthrodesis, performed for posttraumatic crusarthrosis, grade III-IV (according to Kellgren and Lawrence classification), have been analyzes. The conclusions were based on the data of radiographic, clinical examination and the scoring according to the international rating scale AOFAS. Arthrodesis was performed using state-of-the-art fixing implants: with the help of the screws, retrograde intramedullary HAN rod, Ilizarov apparatus for external fixation, wires.Results. In the majority of patients (41%) the main cause of developing posttraumatic crusarthrosis of grade III-IV was unrepaired intraarticular dislocation of the ankle fragments and a large fragment (more than 1/3) of the posterior tibia margin. The best results, i.e. fewer ligamentous ankylosis (32%) and the greatest number of good (39%) and satisfied (54%) results according to AOFAS scale were obtained when crossed screws were used in arthrodesis. It was estimated, that the assessment of clinical and functional signs according to the international scale AOFAS does not reflects the most vital spectrum of life activity indices of patients, therefore, it has been suggested to use additionally individualized indices characterizing the quality of life of patients of various professions, levels of every-day activity and psychological motivation to adequate rehabilitation. Unsatisfied radiographic findings did not always corresponded to the poor clinical results. In 56% of patients with ligamentous ankylosis the result according to AOFAS was good or satisfactory (slight pains in prolonged walking, moving without additional supporting means, absence of evident limping).Conclusion. The worked out concept of modern arthrodesis is as follows: 1) the choice of ankle arthrodesis method and the type of a fixing implant must depend not only on the type of deformation, but on the patient's age, gender traits, diseases contributing to the development of unfavorable treatment results; 2) the best clinical and functional results are connected with the method of fixation providing primary stability, and with regenerative and adaptive capabilities of patients in diverse age groups; 3) the most optimal state-of-the-art implants for arthrodesis are crossed screws for fixation, providing the greatest strength and good primary compression, if there is no marked disorder of blood supply of the articular bones and radical removal of the cartilaginous tissue.

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Long-Term Results After Ankle Arthrodesis: Clinical, Radiological, Gait Analytical Aspects

Cited by 27 publications

References 26 publications

Die Arthrodese des oberen Sprunggelenks über den sog. transfibularen Zugang

Die Arthrodese des oberen Sprunggelenks über den sog. transfibularen Zugang

Die tibiotalokalkaneare Arthrodese mit dem retrograd eingebrachten distalen Femurnagel (DFN)

The Concept of Modern Ankle Joint Arthrodesis in Posttraumatic Crusarthrosis, Grade III–IV

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