Effectiveness and safety of modified sliding chute bone graft plus hollow screw fixation for Tibiotalar joint fusion / 中国组织工程研究

ABSTRACT

BACKGROUND: Tibiotalar joint fusion ways are various, and it is a difficulty in necrotic tibiotalar joint fusion. There are few comparative studies on the repair outcomes of each implant. OBJECTIVE: To compare the effectiveness and safety of modified sliding chute bone graft plus hollow screw fixation with simple screw internal fixation and plate internal fixation for tibiotalar joint fusion. METHODS: Fifty-six patients who underwent tibiotalar joint fusion were Included, Including 16 cases of screw fixation, 22 cases of plate fixation and 18 cases of modified sliding chute bone graft plus hollow screw fixation. Ankle function was compared after simple screw internal fixation, plate internal fixation and modified sliding chute bone graft plus hollow screw fixation. The ankle foot scoring system of American Orthopedic Foot and Anlde Society was used for evaluation. At the same time, the operation time, brace fixation time and fusion time of the three surgical methods ware compared. The gait at the last follow-up was compared. The average follow-up time was 2.4 years. The experiment met the ethical requirements of the First Affiliated Hospital of Harbin Medical University. All patients provided written informed consent for study participation. RESULTS AND CONCLUSION: (1) All the patients obtained exactly bony fusion. Compared with the plate fixation group, the slide bone grafting group had significant advantages in the fusion time and the last gait (P < 0.05), and the screw fixation group had significant advantages in the operation time (P < 0.05). (2) Using the ankle foot scoring system of American Orthopedic Foot and Ankle society, there was no significant difference between the sliding chute bone graft group and the plate fixation group, but both groups were significantly better than the screw fixation group (P < 0.05). (3) Adverse events had not been found in each group. (4) These results suggest that modified sliding chute bone graft plus hollow screw fixation for anlde joint lusion can effectively improve ankle joint fusion rate compared with single screw fixation, which is effective and safe.