Ankle fusion

Multiple techniques for ankle arthrodesis have been described. A transfibular lateral approach between the sural nerve and the lateral branch of the superficial peroneal nerve is utilized. This permits excellent visualization of the ankle joint so that correction of the deformity can readily be achieved under direct visualization. Eighteen ankle fusions carried out through a transfibular approach were reviewed. The fusion site was stabilized with two or more 6.5-mm AO screws. No bone graft was utilized. The follow-up period was from six to 48 months. Ages of the patients ranged from 21 to 68 years. The postoperative regimen was six weeks nonweight-bearing in a short-leg cast, followed by weight bearing in a short-leg cast until union occurred. All fusions but one healed with an average period of 14 weeks of immobilization. No patient experienced wound healing difficulty or disruption of a superficial nerve. The authors believe that this is a simple technique that permits excellent visualization through a safe internervous interval, good bone apposition, rigid interfragmentary fixation and does not require the use of bone graft.