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Related Experiment Videos

Ankle arthrodesis using internal screw fixation.

E S Holt1, S T Hansen, K A Mayo

  • 1Department of Orthopaedics, Harborview Medical Center, Seattle, WA 98104.

Clinical Orthopaedics and Related Research
|July 1, 1991
PubMed
Summary
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External fixation for ankle arthrodesis causes complications. A new screw fixation technique improves fusion rates, especially when high-risk factors like avascular talus are excluded.

Area of Science:

  • Orthopedic Surgery
  • Surgical Techniques
  • Biomaterials and Implants

Background:

  • External fixation for ankle arthrodesis is associated with significant complication rates, including pin tract infections, malunion, and nonunion.
  • Existing methods often require substantial bone removal, potentially compromising anatomical integrity and healing.
  • A need exists for a more reliable and less invasive ankle fusion technique.

Purpose of the Study:

  • To introduce and evaluate a novel ankle arthrodesis technique utilizing cancellous screws for primary fixation.
  • To assess the fusion rates and complication profile of this screw-based method.
  • To identify patient-specific risk factors associated with fusion failure.

Main Methods:

  • Development of an ankle arthrodesis technique using 6.5-mm cancellous screws, with a key screw placed from the posterior malleolus into the talus.

Related Experiment Videos

  • Emphasis on preserving near-normal anatomy by removing only cartilage, not bone.
  • Review of 23 cases treated with an earlier version of the technique, with later modifications including specialized screw placement and strain-relieving bone grafting.

    • Main Results:

    • The overall fusion rate for the reviewed cases was 74%.
    • Avascular talus, pyarthrosis, and spasticity were identified as high-risk factors for nonunion.
    • Excluding high-risk patients, the fusion rate increased to 93%, with only one case of delayed union.

    Conclusions:

    • The developed cancellous screw fixation technique offers a promising alternative for ankle arthrodesis.
    • Patient selection is crucial, as certain conditions significantly increase the risk of fusion failure.
    • The evolved technique demonstrates potential for accurate and complication-free ankle fusion.