Operative Fixation Options for Elective and Diabetic Ankle Arthrodesis.

Area of Science:

• Orthopedic Surgery
• Podiatric Medicine
• Biomedical Engineering

Background:

• Ankle arthrodesis is a definitive treatment for end-stage ankle arthritis, deformities, and post-surgical complications.
• It aims to alleviate pain, correct deformities, and establish a stable, plantigrade foot.
• Various internal and external fixation techniques exist for ankle fusion.

Purpose of the Study:

• To comprehensively analyze midterm to long-term outcomes of ankle arthrodesis.
• To compare outcomes between internal and external fixation methods.
• To evaluate results in both elective and diabetic patient populations.

Main Methods:

• Review of existing literature on ankle arthrodesis outcomes.
• Analysis of studies utilizing internal fixation.
• Analysis of studies utilizing external fixation.
• Evaluation of studies combining internal and external fixation.
• Stratification of results based on elective versus diabetic conditions.

Main Results:

• Ankle arthrodesis with internal fixation demonstrates favorable midterm to long-term outcomes for pain relief and stability in elective cases.
• External fixation shows utility in specific scenarios, particularly for complex deformities or compromised soft tissues.
• Outcomes in diabetic patients require careful consideration due to potential complications, though fusion can be achieved successfully.
• Midterm to long-term success rates are generally high for both fixation methods when indications are appropriately selected.

Conclusions:

• Ankle arthrodesis is a reliable procedure for managing debilitating ankle conditions, offering significant functional improvement.
• Both internal and external fixation methods provide viable options, with technique selection guided by patient-specific factors and clinical context.
• Careful patient selection and management are crucial for optimizing outcomes, especially in the diabetic population.