title: Headless compression screw fixation prevents symptomatic metalwork in arthroscopic ankle arthrodesis.
abstract: BACKGROUND
  Arthroscopic ankle arthrodesis (AAA) is a recognised salvage procedure for end-stage arthritis. Its reported disadvantages include a high rate of re-operation for symptomatic prominence of metalwork. We propose that the use of a headless screw would reduce this re-operation rate.
  
  
  METHODS
  We reviewed 32 AAAs, using the Acutrak™6/7 mm headless screw fixation system, to determine peri-operative parameters and complication rates.
  
  
  RESULTS
  At an average of 22 months follow-up, 28 (88%) had united radiologically. There were 2 stable fibrous non-unions not requiring further intervention. Of the other 2, one was successfully revised using an open technique, and the other patient died of unrelated causes. There were no other complications in this series, with no cases of metalwork removal for prominence or pain.
  
  
  CONCLUSIONS
  Using a headless screw fixation for arthroscopic ankle arthrodesis prevents symptomatic metalwork prominence and the requirement for removal.
authors.affiliation: Trauma and Orthopaedic Directorate, University Hospitals Bristol NHS Foundation Trust, Marlborough Street, Bristol BS2 8HW, United Kingdom. koye@doctors.org.uk
authors.forename: Adekoyejo A
authors.initials: AA
authors.lastname: Odutola
authors.forename: Barnaby D
authors.initials: BD
authors.lastname: Sheridan
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Kelly
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects / Q000295:instrumentation*; D001863:Bone Screws; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control