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Open Ankle Arthrodesis: A Retrospective Analysis Comparing Different Fixation Methods.

Stein B M van den Heuvel1, Diederick Penning1, Tim Schepers2

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The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|August 7, 2021
PubMed
Summary

Open ankle arthrodesis is the gold standard for end-stage ankle arthritis. Intramedullary nail fixation shows high union rates and low complications, offering excellent results for this condition.

Keywords:
complicationfusionosteoarthritispost-traumaticrisk factorsunion

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Area of Science:

  • Orthopedic Surgery
  • Podiatric Medicine
  • Biomedical Engineering

Background:

  • End-stage ankle arthritis presents varied surgical outcomes, complications, and union rates.
  • Open ankle arthrodesis is the established gold standard treatment.
  • Evaluating fixation methods is crucial for optimizing outcomes.

Purpose of the Study:

  • To assess union and complication rates for different ankle arthrodesis fixation methods.
  • To identify risk factors associated with fixation techniques in end-stage ankle arthritis.
  • To compare screw, plate, and intramedullary nail fixation outcomes.

Main Methods:

  • Single-center retrospective study of 42 ankles in 41 patients with ankle osteoarthritis.
  • Patients underwent open ankle arthrodesis with screw, plate, or intramedullary nail fixation.
  • Data collected on union rates, complication types, and follow-up duration.

Main Results:

  • Overall union rate was 97.6% (41/42 ankles); overall complication rate was 21.4% (9 events).
  • Plate fixation showed significantly higher infection rates (p=0.017) compared to screw and intramedullary nail.
  • Intramedullary nail fixation demonstrated a high union rate and low complication rate.

Conclusions:

  • Open ankle arthrodesis achieves good clinical results across various fixation methods.
  • Intramedullary nail fixation is particularly effective for end-stage ankle arthritis, offering superior outcomes.
  • Careful consideration of fixation method is essential to minimize complications in ankle fusion surgery.