Improvement in technique for arthroscopic ankle fusion: results in 15 patients

We retrospectively assessed time until consolidation, complications, and functional results according to Morgan from the clinical charts and radiographs of 15 arthroscopic ankle fusions. In 11 patients unilateral distraction and crossed screw placement over the fusion area through tibia and fibula were used (group A); in 4 patients a technique of bilateral distraction and parallel screw placement from the dorsal side of the tibia into the neck of the talus was used (group B). In group A there were two cases of insufficient compression at the arthrodesis site, three cases of suboptimal compression, and five cases of malposition of the screws. In all cases in group B good compression and fixation was achieved, and no case of malpositioning of screws occurred. There was nonunion in 3 of 11 patients in group A and in none of the four patients in group B. Time until fusion was 23.3 in group A and 12.5 weeks in group B. Functional results were better in group B. The initial experiences with our technique of bilateral distraction and parallel screw placement are therefore promising. Screw placement is easier and optimal compression and fixation are achieved. We feel that this technique should be considered when performing an arthroscopic ankle fusion.