[Treatment of geriatric ankle osteoarthritis by arthrodesis with screw fixation through lateral malleolus osteotomy]

Objective: To evaluate the Treatment effect of geriatric ankle osteoarthritis by arthrodesis with screw fixation through lateral malleolus osteotomy. Methods: Thirty-three patients with severe osteoarthritis according to the classification of Takakura-Tanakawere treated by ankle arthrodesis through lateral malleolus osteotomy with screw fixation from January 2010 to June 2015. Twenty-five patients were combined with more than 1 internal diseases. Twenty-six patients owned ankle injury history. Clinical and radiologic evaluations were performed before surgery and at the most recent follow-up. Results: The American Orthopaedic Foot and Ankle Society scale was (50.9±12.0) points beforesurgery and (78.8±9.6) points at the most recent follow-up (P<0.01). The visual analogue scalein last follow up was significantly decreased to (1.7±1.1), compared with (6.1±1.7)preoperatively.Seven patients were accompanied with incision complications. 27 patients(81.8 percent) reached complete solid fusion , which was confirmed by CT. 4 patients was partially bony fused, which could also perform weight-bearing walk. The other 2 patients with nonunion were reoperated lastly. Conclusions: Ankle arthrodesis by screw fixation through lateral malleolus osteotomy is the preferable surgical treatment option in patients with end-stage geriatric ankle arthritis, showing high reliability and effectivity in pain relieving and function improvement. Incision and bony healing complications should draw attention especially in patients combined with internal disease.