Transfibular ankle arthrodesis using burring, curettage, multiple drilling, and fixation with two retrograde screws through a single lateral incision.
To review the outcome of 23 ankle arthrodeses using burring, curettage, multiple drilling, and fixation with 2 retrograde screws through a single lateral incision.



Records of 22 consecutive patients aged 39 to 79 (mean, 62.4) years who underwent 23 ankle arthrodeses for end-stage ankle arthritis were reviewed. Through a single lateral incision, articular cartilage was removed using burring and curettage, and multiple holes were drilled using a Kirschner wire, followed by fixation with 2 retrograde screws. The resected distal fibula was fixed to the distal part of the talus and tibia. The position of the ankle and subtalar joint arthrosis was assessed by 2 orthopaedic specialists. Pre- and post-operative American Orthopaedic Foot and Ankle Society (AOFAS) scores were evaluated.



The mean operating time was 122 minutes. The mean follow-up period was 41 months. The mean postoperative ankle alignment was suboptimal: 2.7º varus, 6.7º plantar flexion, and 2.9º internal rotation. The mean AOFAS score improved from 30 to 71 (p<0.01). The postoperative varus ankle alignment was not associated with the AOFAS score (r= -0.13, p=0.569). Of the 23 cases, one was nonunion and 22 achieved bone union after a mean of 5.4 (range, 2-16) months; 3 of them were delayed union. Despite bone union, 7 patients complained of persistent pain; 4 of them had progressive arthrosis of the adjacent subtalar joints (n=2) or subtalar and talonavicular joints (n=2).



Ankle arthrodesis using burring, curettage, multiple drilling, and fixation with 2 retrograde screws achieved a high union rate and acceptable functional score without serious complications.
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
H J
HJ
Lee
W K
WK
Min
J S
JS
Kim
S D
SD
Yoon
D H
DH
Kim
D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000601:surgery*; D001168:Arthritis / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017760:Bone Malalignment / Q000209:etiology; D001863:Bone Screws; D005260:Female; D005360:Fibula / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D013380:Subtalar Joint; D013628:Talus / Q000601:surgery; D013977:Tibia / Q000601:surgery
ankle joint; arthritis; arthrodesis