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[Tibiotarsal arthrodesis in a septic milieu]
Summary
This study evaluated 28 ankle fusions for septic conditions, finding external fixation crucial for achieving bone contact and successful fusion outcomes in complex cases.
Area of Science:
- Orthopedic Surgery
- Infectious Disease Management
Context:
- Septic arthritis and severe compound fractures pose significant challenges to ankle joint integrity.
- Traditional fusion methods may be insufficient for extensive bone loss and contamination.
Purpose:
- To assess the efficacy of ankle arthrodesis using external fixation and bone grafting in managing septic ankle conditions.
- To evaluate different surgical techniques, including the Papineau method, for achieving fusion in complex cases.
Summary:
- Twenty-eight ankle fusions were performed for septic causes (23 septic arthritis, 5 compound fractures).
- Arthrodesis involved wide excision, external fixation, and secondary bone grafting in most cases.
- Satisfactory bony contact was achieved in 13 cases; 18 of 24 patients had good final results, with fusion failures and persistent sinuses noted.
Impact:
- Highlights the importance of wide excision and external fixation for successful ankle fusion in septic scenarios.
- Suggests the Papineau method as a primary option for recent comminuted fractures with skin loss.
- Provides insights into managing challenging ankle reconstructions with infection.