[Charnleys arthrodesis by modified and method of external fixation.]

The authors present an inovated Charnley's operation method of ankle arthrodesis by a modified anterior approach and method of external fixation. They evaluate a group of 26 patients operated on the period from 1993 to 1996. The patients were operated on 14 cases for purulent ankle arthritis, in 7 cases for posttraumatic osteomyelitis, in 4 cases for posttraumatic ankle arthritis and 2 operations were made for neurotrophic foot in a patient with meningomyelocoela. In all cases this arthrodesis was stabilized with the aid of external fixation PH (Pilnácek - Hrubý) fix. This fixation method allows a quick and comfortable application, fixation, one or two planes and a possibility to correct the position also within the postoperational treatment without the necessity to redrill the nails already introduced. The anterior arcuate operational approach is advantageous for its very good space orientation, which is necessary for articular faces resection. It also solves the problem of soft tissues relative surplus. This problem is first of all of negative influence when using anterior longitudinal approach by difficult or even impossible suture. This approach makes possible a skin resection as large as necessary for suture without tension. In addition, it is gentle to the tendons, nerves and vessels, so it reduces frequent chronical swelling. This method allows an early loading and leads to a quick fusion of resected tissues and so soon sets the operated patient free of difficulties. Key words: ankle arthrodesis, external fixation PH fix, anterior arcuate approach.