Clinical and biomechanical trials have shown
that rigid internal fixation during ankle arthrodesis leads to
increased rates of union and is associated with a reduced
infection rate, union time, discomfort and earlier mobilisation
compared with other methods. We describe our
technique of ankle arthrodesis using anterior plating with
a narrow dynamic compression plate (DCP). Between 2004
and 2007, 29 patients with a mean age of 24.4 years (range
18–42) had ankle arthrodesis using an anteriorly placed
narrow DCP. Twenty-two patients were post-traumatic and
seven were paralytic (five after spine fracture and two after
common peroneal nerve injury). Follow-up was between 12
and 18 months (average 14 months). A rate of fusion of
100% was achieved at an average of 12.2 weeks. According
to the Mazur ankle score, 65.5% had excellent, 20.7% good
and 13.8% fair results. Ankle arthrodesis using an anteriorly
placed narrow DCP is a good method to achieve ankle
fusion in many types of ankle arthropathies.
Introduction
Ankle arthrodesis has become a well-established surgical
procedure for severe ankle arthropathy. The rate of union
varies according to the surgical technique and the type of
patient. While successful results have been reported by
many [1, 2], nonunion rates as high as 40% [3] have been
described. Numerous complications have been reported
including nonunion, delayed union, breakdown of union,
pin tract infection, delayed wound healing, skin necrosis
and below knee amputation for intractable pain and
infection [4–7]. To date more than 30 different methods
have been reported with different surgical approaches,
articular surface preparation, types of fixation, use of bone
graft and postoperative care [8, 9]. Clinical and biomechanical
trials have shown that rigid internal fixation leads
to increased rates of union and is also associated with a
reduced infection rate, a decreased time of union, less
discomfort, and earlier mobilisation compared with other
methods [9, 10].
This study aimed at assessing the rate, time of union and
complications using anterior plating for ankle arthrodesis.