Treatment of infected arthrodesis of the ankle

In arthrodesis of the ankle joint the use of external fixation can cause severe problems owing to pintrack infections. As long as infection is active, bony consolidation of the arthrodesis is delayed. In the potentially infected area a normal internal osteosynthesis is risky. Our treatment rationale comprises a two-stage procedure with treatment of infection first by implant removal, thorough debridement and implantation of Septopal beads and then secondary internal stabilization with an antibiotic-releasing bone plate. Of the 42 cases amputation had to be performed in 3; of the remaining 39, infection was cured long-term in 36. In all 39 a stable bony fusion was achieved.