[Iliac crest bone graft with vascular pedicle for treatment of fibrous ankylosis of the ankle].
OBJECTIVE
63-year-old man with a painful fibrous ankylosis of the left ankle in spite of two surgical attempts at arthrodesis. The subtalar joint had been fused 3 years previously during a reconstruction of the posterior tibial tendon. The severe, activity-related pain was partially due to a reflex sympathetic dystrophy. Wearing of orthopedic shoes did not relieve the symptoms; a below-knee amputation had been considered.


METHODS
Tibiotalar arthrodesis in functional position with a free pedicled iliac bone graft.


METHODS
Microsurgical harvesting of a pedicled iliac bone graft. Debridement of the fibrous ankylosis and transplantation of the bone graft into an anterior tibiotalar groove.


RESULTS
Bony fusion within 3 months. Pain-free weight bearing. The favorable outcome persisted after 1 year.
Zollinger-Kies
Hans
H
Facharzt für Orthopädische Chirurgie FMH, Bahnhofstrasse 56, CH-8001 Zürich, Switzerland. h.zollinger-kies@access.unizh.ch
Largiader
Jon
J
D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000844:Ankylosis / Q000601:surgery*; D018771:Arthralgia / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control*; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods*; D005355:Fibrosis; D006801:Humans; D007085:Ilium / Q000098:blood supply / Q000637:transplantation*; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D013628:Talus / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013977:Tibia / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome