Arthrodesis of the infected ankle and subtalar joint: technique, indications, and results of 45 consecutive cases.
OBJECTIVE
To analyze the results of 45 patients after ankle arthrodesis in the presence of joint infection.


METHODS
Arthrodesis was performed with two compression screws and an anterior plate in 29 patients and with two compression screws only in 16 patients. In all patients, additional stabilization with external fixation was used. In 29 patients, isolated fusion of the ankle joint was performed; in 13 patients, the ankle and subtalar joints were fused, and in 3 patients, isolated arthrodesis of the subtalar joint was performed.


RESULTS
In 39 of 45 patients (86.6%), solid fusion was obtained. Nonunions occurred in 6 patients (13.4%). A below-knee amputation was necessary for one patient. Full weight-bearing was achieved after 21.6 weeks on average. Thirty-two patients returned to work after 35.5 weeks on average. Five of the six patients with failed ankle fusion needed special shoes; in one patient, a below-knee amputation was performed. A total of 33.3% of failed ankle fusions were associated with systemic disorders such as diabetes mellitus, and other concomitant diseases compromising local arterial blood supply and proprioception.


CONCLUSIONS
Our results prove that limb salvage is possible even in complex ankle and subtalar pathology by thorough fusion by using a number of different techniques.
Richter
D
D
Department of Surgery, Berufsgenossenschaftliche Kliniken Bergmannsheil, Trauma Center, School of Medicine, University of Bochum, Germany. dirkr@ukb.de
Hahn
M P
MP
Laun
R A
RA
Ekkernkamp
A
A
Muhr
G
G
Ostermann
P A
PA
D000328:Adult; D000368:Aged; D000843:Ankle Joint; D001170:Arthritis, Infectious / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001424:Bacterial Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001860:Bone Plates; D001863:Bone Screws; D002183:Canes; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D011859:Radiography; D012189:Retrospective Studies; D016879:Salvage Therapy; D012775:Shoes; D013380:Subtalar Joint; D016896:Treatment Outcome; D016474:Weight-Bearing