Arthrodesis of the Ankle: New Approaches

Abstract

End-stage arthritis of the ankle is a chronic and disabling condition that often requires surgical intervention. Arthrodesis of the ankle has long been the preferred surgical treatment for the most severe forms of this condition. Although ankle arthrodesis is an excellent procedure for eliminating pain, it can be accomplished through many different techniques, all of which have associated limitations, including wound-related complications, nonunion, malunion, and the potentially premature degeneration of joints adjacent to the ankle. To limit the risk of these problems, various attempts have been made to develop improved techniques and protocols for arthrodesis of the ankle. This article reviews the most popular techniques currently in use for ankle arthrodesis, alternatives to these techniques, and the role of these alternatives in different clinical settings, including their strengths and shortcomings in various settings. The review is limited to tibiotalar arthrodesis and does not cover tibiotalocalcaneal arthrodesis, which is done through its own set of techniques and fixation methods.

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