Primary union of ankle arthrodesis: review of a single institution/multiple surgeon experience

A review of 37 ankle arthrodesis procedures done over a 12-year period by multiple surgeons at a single institution was performed. Six different techniques were used during the study period. The initial success rate, defined as cases achieving a solid union after the index procedure, was 65%. Seven additional patients went on to a solid arthrodesis after subsequent surgical procedures, for an ultimate success rate of 84%. The initial success rate varied considerably depending on the surgical technique used, and ranged from 29% with the RAF fibular strut technique to 100% with T-plate fixation. Although there are many variables that influence the success or failure of ankle arthrodesis, in our hands rigid internal fixation gave the most predictable rate of primary union.