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Revision ankle fusion using internal compression arthrodesis with screw fixation
J G Anderson1, J C Coetzee, S T Hansen
1Lancaster Orthopedic Group, Pennsylvania 17601, USA.
Foot & Ankle International
|May 1, 1997
Summary
Revision ankle fusion using internal compression arthrodesis with screw fixation achieved an 85% union rate. While beneficial for most, this demanding procedure carries a high complication risk, with many patients experiencing residual pain.
Area of Science:
- Orthopedic Surgery
- Reconstructive Surgery
Background:
- Revision ankle fusion addresses failed index procedures like nonunion and malunion.
- Internal compression arthrodesis with screw fixation is a common surgical technique.
Observation:
- This study reviewed 20 revision ankle fusions for nonunion, malunion, infected nonunion, or avascular necrosis.
- Follow-up averaged 30 months, assessing clinical, functional, and radiographic outcomes.
Findings:
- An 85% fusion rate was achieved after revision surgery, with a mean time to fusion of 6 months.
- 12 patients (60%) required 19 additional operations, including three amputations for chronic infection.
- 17 patients (85%) reported satisfaction, despite a high complication rate and potential for residual pain.
Implications:
- Revision ankle fusion can be effective for nonunion and malunion but is technically challenging.
- Aggressive management of infections and accurate alignment are crucial for successful outcomes.
- Amputation may be considered for intractable pain in well-aligned fusions to improve function.