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

Area of Science:

• Orthopedic Surgery
• Surgical Innovation

Context:

• Ankle arthrodesis is a procedure to fuse the ankle joint, often necessary for severe arthritis, osteomyelitis, or deformities.
• Traditional anterior approaches can present challenges with soft tissue management and wound closure.
• External fixation offers a method for stabilizing bone fusions, allowing for adjustments and early mobilization.

Purpose:

• To present and evaluate an innovative ankle arthrodesis technique combining a modified anterior arcuate approach with PH (Pilnácek-Hrubý) external fixation.
• To assess the efficacy and outcomes of this combined surgical method in a cohort of patients with diverse ankle pathologies.

Summary:

• The study evaluated 26 patients undergoing ankle arthrodesis between 1993-1996 for conditions including purulent arthritis, posttraumatic osteomyelitis, posttraumatic arthritis, and neurotrophic foot.
• The procedure utilized a modified anterior arcuate approach for improved visualization and soft tissue handling, coupled with PH external fixation for stable joint immobilization.
• The PH fix allowed for multi-planar fixation, intraoperative and postoperative adjustments without re-drilling, and facilitated early weight-bearing.

Impact:

• The anterior arcuate approach facilitated easier resection of articular surfaces and managed soft tissue surplus effectively, avoiding tension during wound closure.
• This technique demonstrated gentleness to surrounding neurovascular structures, potentially reducing chronic swelling.
• The method promoted early loading and rapid fusion, leading to quicker patient recovery and reduced post-operative complications.