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[Ankle arthrodesis with intramedullary compression nailing].

T Mückley1, T Schütz, S Srivastava

  • 1Berufsgenossenschaftliche Unfallklinik, Murnau. T.Mueckley@gmx.de

Der Unfallchirurg
|November 25, 2003
PubMed
Summary

Intramedullary compression nailing is an effective method for tibiotalar arthrodesis in severe ankle arthropathy, offering high stability and reduced soft tissue damage. This surgical technique leads to successful fusion in most patients, allowing for early weight-bearing and pain relief.

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Area of Science:

  • Orthopedic Surgery
  • Podiatric Medicine
  • Biomedical Engineering

Background:

  • Tibiotalar arthrodesis is the preferred treatment for disabling ankle arthropathy.
  • Ankle arthroplasty outcomes are not yet convincing.
  • Internal fixation and compression are increasingly favored in surgical techniques.

Purpose of the Study:

  • To evaluate the effectiveness of intramedullary compression nailing for tibiotalar arthrodesis.
  • To assess fusion rates, complications, and patient outcomes.
  • To highlight the advantages of this technique in managing severe ankle arthropathy.

Main Methods:

  • 137 tibiotalar fusions were performed using a specialized intramedullary compression nail.
  • Technique involved cartilage and/or bony joint surface resection for alignment.

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  • A dowel technique with bone grafting from the lateral malleolus was employed.
  • 110 patients were evaluated during follow-up.

    • Main Results:

    • Primary union achieved in 90.0% of cases (99/110).
    • An additional 5.5% healed after recompression and bone grafting.
    • Nonunion occurred in 4.5% of cases (5/110).
    • Complications included tibial shaft fracture, hematoma, and infections (3 superficial, 8 deep).
    • 70 patients (63.6%) reported sufficient pain relief; 33.6% had unchanged symptoms.

    Conclusions:

    • Intramedullary compression nailing is an effective technique for tibiotalar arthrodesis in severe ankle arthropathy.
    • The technique offers advantages such as limited soft tissue damage and high primary stability.
    • Early weight-bearing is facilitated by the high primary stability achieved with this method.