ANKLE ARTHRODESIS WITH THREE CANCELLOUS SCREWS

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Abstract

Purpose — to evaluate the efficiency of the proposed method of arthrodesis by three cancellous screws in patients with posttraumatic arthrosis of the ankle joint.

Materials and Methods. After removal of talus and tibia cartilage and autografting the proposed method features placement of foot into the optimal position and fixation of the ankle joint with three cancellous screws. 23 patients with posttraumatic ankle deformity arthrosis of grades III–IV underwent surgery according to the described procedure. Condition of all patients prior to and after the surgery was evaluated using the international ankle and rear foot assessment scale of the American Orthopedic Society of the Foot and Ankle (AOFAS).

Results. In 20 patients (88%) the ankle ankylosis was reported within 2.5 months, which was confirmed by X-ray examination. In 2 patients (8%) the ankylosis took place in the period up to 4 months. Loss of the correct position of the foot with screws migration was reported in one patient (4%). The authors observed that patients with postoperative deviation of the tibiotalar angle not exceeding 5 degrees as compared to a healthy limb demonstrated the best functional outcomes.

Conclusion. The suggested technique ensures a secure fixation of talus in a predetermined position, a single-step compression between the closed joint surfaces and allows an early effective rehabilitation.

About the authors

V. V. Khominets

Kirov Military Medical Academy.

Author for correspondence.
Email: fake@neicon.ru

Vladimir V. Khominets — Dr. Sci. (Med.), professor, head of Department of Military Traumatology and Orthopedics.

6, ul. Akad. Lebedeva, 194044, St. Petersburg.

Russian Federation

S. V. Mikhailov

Kirov Military Medical Academy.

Email: fake@neicon.ru

Sergey V. Mikhailov — Cand. Sci. (Med.), senior lecturer of Department of Military Traumatology and Orthopedics.

6, ul. Akad. Lebedeva, 194044, St. Petersburg.

Russian Federation

D. A. Shakun

Kirov Military Medical Academy.

Email: fake@neicon.ru

Dmitry A. Shakun — Cand. Sci. (Med.), lecturer of Department of Military Traumatology and Orthopedics.

6, ul. Akad. Lebedeva, 194044, St. Petersburg.

Russian Federation

S. E. Shumagaziev

Kirov Military Medical Academy.

Email: fake@neicon.ru

Sayan E. Zhumagaziev — resident of Department of Military Traumatology and Orthopedics.

6, ul. Akad. Lebedeva, 194044, St. Petersburg.

Russian Federation

A. V. Komarov

Kirov Military Medical Academy.

Email: fake@neicon.ru

Artem V. Komarov — resident of Department of Military Traumatology and Orthopedics.

6, ul. Akad. Lebedeva, 194044, St. Petersburg.

Russian Federation

References

  1. Ежов М.Ю. Стопа. Дегенеративно-дистрофические заболевания суставов стопы и голеностопного сустава. Н. Новгород; 2011. С. 12-13 с.
  2. Рукина Н.Н., Ежов М.Ю., Ежов Ю.И. Особенности распределения нагрузки на отделы стопы в различных биомеханических условиях. Вестник Ивановской медицинской академии. 2012;17(3):32-36.
  3. Омельченко Т.Н. Переломы лодыжек и быстропрогрессирующий остеоартроз голеностопного сустава: профилактика и лечение. Ортопедия, травматология и протезирование. 2013;(4):35-40.
  4. Saltzman C.L., Salamon M.L., Blanchard G.M., Huff T., Hayes A., Buckwalter J.A., Amendola A. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J. 2005;25:44-46.
  5. Thomas R.L., Sathe V., Habib S.I. The use of intramedullary nails in tibiotalocalcaneal arthrodesis. J Am Acad Orthop Surg. 2012;20(1):1-7. doi: 10.5435/JAA OS-20-01-001.
  6. Тихилов Р.М., Корышков Н.А., Емельянов В.Г., Стоянов А.В., Журавлев А.В., Привалов А.М. Опыт эндопротезирования голеностопного сустава в Российском научно-исследовательском институте травматологии и ортопедии им. Р.Р. Вредена. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2009;(3):56-60.
  7. Михайлов К.С., Емельянов В.Г., Тихилов Р.М., Кочиш А.Ю., Сорокин Е.П. Обоснование выбора операций артродезирования или эндопротезирования у пациентов с артрозом голеностопного сустава. Травматология и ортопедия России. 2016;(1):21-32. doi: 10.21823/2311-2905-2016-0-1-21-32.
  8. Яременко Д.А., Бабуркина Е.П., Кишкарь А.В. Артродез при последствиях осложнений травм голеностопного сустава. Ортопедия, травматология и протезирование. 2000;(3):77-81.
  9. Hintermann B., Barg A., Knupp M., Valderrabano V. Conversion of painful ankle arthrodesis to total ankle arthroplasty. J Bone Joint Surg Am. 2009;91(4):850-858. doi: 10.2106/JBJS.H.00229.
  10. Plaass C., Knupp M., Barg A., Hintermann B. Anterior double plating for rigid fixation of isolated tibiotalar arthrodesis. Foot Ankle Int. 2009;30(7):631-639. D OI: 10.3113/FAI.2009.0631.
  11. Valderrabano V., Horisberger M., Russell I., Dougall H., Hintermann B. Etiology of ankle osteoarthritis. Clin Orthop Relat Res. 2009;467(7):1800-1806. D OI: 10.1007/s11999-008-0543-6.
  12. Hendrickx R.P., Stufkens S.A., De Bruijn E.E. et al. Medium to long-term outcome of ankle arthrodesis. Foot Ankle Int. 2011;32:940-947.
  13. Onodera T., Majima T., Kasahara Y., Takahashi D., Yamazaki S., Ando R. et al. Outcome of transfibular ankle arthrodesis with Ilizarov apparatus. Foot Ankle Int. 2012;33:964-968.
  14. Hendrickx R.P., Kerkhoffs G.M., Stufkens S.A., van Dijk C.N., Marti R.K. Ankle fusion using a 2-incision, 3-screw technique. Oper Orthop Traumatol. 2011;23(2):131-140. doi: 10.1007/s00064-011-0015-0.
  15. Khanfour A.A. Versatility of Ilizarov technique in difficult cases of ankle arthrodesis and review of literature. Foot Ankle Surg. 2013; 19(1):42-47. D OI: 10.1016/j. fas.2012.10.001.
  16. Thomas R., Daniels T.R., Parker K. Gait analysis and functional outcomes fol-lowing ankle arthrodesis for isolated ankle arthritis. J Bone Joint Surg Am. 2006;88(3):526-535.
  17. Архипов C.B., Лычагин A.B. Современные аспекты лечения посттравматического деформирующего артроза голеностопного сустава. Вестник травматологии и ортопедии им. Н.Н. Приорова. 2000;(4):64-67.
  18. Frey C, Halikus NM, Vu-Rose T, Ebramzadeh E. A review of ankle arthrodesis: predisposing factors to nonunion. Foot Ankle Int. 1994; 15:581-584.
  19. Vanderwilde R., Staheli L.T., Chew D.E., Malagon V. Measurements on radiographs of the foot in normal infants and children. J Bone Joint Surg Am. 1988;70(3):407-415.
  20. DeHeer P.A., Catoire S.M., Taulman J., Borer B. Ankle arthrodesis: a literature review. Clin Podiatr Med Surg. 2012;29(4):509-527. doi: 10.1016/j.cpm.2012.07.001.
  21. Kitaoka H.B., Romness D.W. Arthrodesis for failed ankle arthroplasty. J Arthroplasty. 1992;7(3):277-284.
  22. Schepers T., Ginai A.Z., Mulder P.G., Patka P. Radiographic evaluation of cal-caneal fractures: to measure or not to measure. Skeletal Radiol. 2007;36(9):847-852. doi: 10.1007/s00256-007-0330-6.
  23. Fuchs S., Sandmann C., Skwara A., Chylarecki C. Quality of life 20 years after arthrodesis of the ankle. A study of adjacent joints. J Bone Joint Surg Br. 2003;85(7): 994-998.
  24. Gordon D., Zicker R., Cullen N., Singh D. Open ankle arthrodeses via an anterior approach. Foot Ankle Int. 2013;34(3):386-391. doi: 10.1177/1071100713477385.
  25. DeOrio J.K., Farber D.C. Morbidity associated with anterior iliac crest bone grafting in foot and ankle surgery. Foot Ankle Int. 2005;26(2):147-151. D OI: 10.1177/107110070502600206.
  26. Weatherall J.M., Mroczek K., McLaurin T., Ding B., Tejwani N. Post-traumatic ankle arthritis. Bull Hosp Jt Dis (2013). 2013;71(1):104-112.
  27. Wheeler J., Sangeorzan A., Crass S.M., Sangeorzan B.J., Benirschke S.K., Hansen S.T. Locally generated bone slurry accelerated ankle arthrodesis. Foot Ankle Int. 2009;30(7):686-689. doi: 10.3113/FAI.2009.0686.
  28. Whitehouse M.R., Lankester M.A., Winson I.G., Hepple S. Bone graft harvest from the proximal tibia in foot and ankle arthrodesis surgery. Foot Ankle Int. 2006;27(11):913-916. doi: 10.1177/107110070602701108.
  29. Ahlmann E., Patzakis M., Roidis N., Shepherd L., Holtom P. Comparison of anterior and posterior iliac crest bone grafts in terms of harvest-site morbidity and functional outcomes. J Bone Joint Surg Am. 2002;84-A(5):716-720.
  30. Buck P., Morrey B.F., Chao E.Y. The optimum position of arthrodesis of the ankle. A gait study of the knee and ankle. J Bone Joint Surg Am. 1987;69(7):1052-1062.
  31. Abdo R.V., Wasilewski S.A. Ankle arthrodesis: a longterm study. Foot Ankle. 1992;13(6):307-312.
  32. Coester L.M., Saltzman C.L., Leupold J., Pontarelli W. Long-term results following ankle arthrodesis for post-traumatic arthritis. J Bone Joint Surg Am. 2001;83(2):219-228.
  33. G lazebrook M. End-stage ankle arthritis: magnitude of the problem and solutions. Instr Course Lect. 2010; 59:359-365.
  34. Segal A.D., Shofer J., Hahn M.E., Orendurff M.S., Ledoux W.R., Sangeorzan B.J. Functional limitations associated with end-stage ankle arthritis. J Bone Joint Surg Am. 2012;94(9):777-783. doi: 10.2106/JBJS.K.01177.

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