ABSTRACT
PURPOSE: The purpose of this study was to compare the clinical and radiologic results of arthrodesis between anterior approach and transfibular approach arthrodesis in ankle arthritis. MATERIALS AND METHODS: There were 61 cases of ankle arthritis treated by anterior or transfibular ankle arthrodesis in our hospital from April 2008 to March 2012. We investigated 29 cases (27 patients) who underwent ankle arthrodesis with an anterior approach (15 cases) and transfibular approach (14 cases), and were followed for over two years. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, pain visual analogue scale (VAS), and subjective satisfaction degrees were evaluated. In addition, ankle coronal and sagittal alignments were evaluated using plain radiographs at 6 and 24 months, postoperatively. RESULTS: Clinically, preoperative mean AOFAS score and VAS was 41.3 and 6.4, and were changed to 58.9 and 3.3 postoperatively in the anterior approach group. In the transfibular approach group, preoperative mean AOFAS score was 36.6 and VAS was 7.1, and they were changed to 54.9 and 3.4 postoperatively. However, no significant differences in the clinical results were observed between the two groups (p=0.297). Duration of attaining union was 8.1 weeks in the anterior approach group and 10.4 weeks in the transfibular approach group. Complications were delayed union in one case, nonunion in three cases, cancellous screw breakage in three cases, and complex regional reflex syndrome in one case. CONCLUSION: After transfibular ankle arthrodesis as treatment of ankle osteoarthritis, the tendency for valgus angulation of the ankle at the final follow-up was observed and 6.5 mm cancellous screw breakage occurred frequently. Therefore, in order to achieve better stability, it is necessary to use 6.5 mm cannulated screws rather than 6.5 mm cancellous screws for ankle arthrodesis.
Subject(s)
Ankle , Arthritis , Arthrodesis , Follow-Up Studies , Foot , Osteoarthritis , ReflexABSTRACT
PURPOSE: We analyse and report the result of transfibular ankle arthrodesis using lateral malleolar saving procedureversus lateral malleolar sacrificing procedure. MATERIALS AND METHODS: Eighteen cases of transfibular ankle arthrodesis which were performed since 2001 were included. We devided them into lateral malleolar saving and lateral malleolar sacrificing groups. We reattached and fixed lateral malleolus in 10 cases and sacrificed malleolus for morcelized bone graft in 8 cases. We evaluated clinical results by AOFAS ankle-hindfoot score, visual analogue scale (VAS) and radiological results by union time. Complications and subjective satisfaction degrees were also recorded and compared between two groups. RESULTS: Preoperative mean AOFAS score was 32 points (16~41) and VAS was 7.5 points (7~8) and they were changed into 68.6 points (61~77) and 2.8 points (2~4) postoperatively. There was no significant difference in clinical results between the two groups even though lateral malleolar saving group showed higher AOFAS score (69.4) than lateral malleolar sacrificing group (67.7). Duration of getting union was 11.3 weeks in lateral malleolar saving group and 10.6 weeks in lateral malleolar sacrificing group. There was no difference in subjective satisfaction level. There were one delayed union and one nonunion in lateral malleolar sacrificing group and one nonunion in lateral malleolar saving group. CONCLUSION: There was no difference in clinical and radiological results between lateral malleolar saving group and lateral malleolar sacrificing group of transfibular ankle arthrodesis. Therefore it may not necessary to sacrifice lateral malleolus for bone graft except very selective case for which heavy graft is needed.
Subject(s)
Animals , Ankle , Arthritis , Arthrodesis , TransplantsABSTRACT
PURPOSE: We analyzed the clinical and radiological results of transfibular ankle arthrodesis for posttraumatic arthritis. MATERIALS AND METHODS: Eighteen cases of transfibular ankle arthrodesis were followed for more than 12 months postoperatively. Mean age was 55 years, and the mean follow-up period was 2.9 years. Preoperative and postoperative AOFAS ankle-hindfoot scores, operative times, postoperative complications and patients satisfaction level were checked. Radiologically preoperative ankle deformity, time to union, position of fusion, residual tarsal motion arc and degenerative changes of adjacent foot joints were evaluated. RESULTS: At the last follow-up, the mean AOFAS ankle-hindfoot score had increased from a preoperative 41 points to 79 points. Sixteen patients (89%) were satisfied with the result. The mean operative time was 108 minutes. Three cases of chronic tear of the peroneus brevis tendon were treated. Mean time to radiological union was 13.1 weeks. No degenerative changes in adjacent foot joints were observed at the last follow up. Two cases (11%) of nonunion and one case (5.5%) of delayed union were observed. Revision of arthrodesis was performed in one case of nonunion. CONCLUSION: Satisfactory results were obtained after transfibular ankle arthrodesis for posttraumatic arthritis. Long-term follow up is needed to evaluate the effects of ankle arthrodesis upon adjacent foot joints.