Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Ankle Arthrodesis Outcomes in Ankle Osteoarthritis: Comparison between Anterior Approach and Transfibular Approach

족근 관절 관절염에서 족관절 유합술의 결과: 전방 도달법과 경비골 도달법 비교

  • Pak, Chi Hyoung (Department of Orthopaedic Surgery, Chosun University Hospital, Chosun University College of Medicine) ;
  • Lee, Jun Young (Department of Orthopaedic Surgery, Chosun University Hospital, Chosun University College of Medicine) ;
  • Jeong, Yeon Joo (Department of Orthopaedic Surgery, Chosun University Hospital, Chosun University College of Medicine)
  • 박치형 (조선대학교 의과대학 조선대학교병원 정형외과학교실) ;
  • 이준영 (조선대학교 의과대학 조선대학교병원 정형외과학교실) ;
  • 정연주 (조선대학교 의과대학 조선대학교병원 정형외과학교실)
  • Received : 2014.10.06
  • Accepted : 2014.10.31
  • Published : 2014.12.15
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Abstract

Purpose: The purpose of this study was to compare the clinical and radiologic results of arthrodesis between anterior approach and transfibular approach arthrodesis in ankle arthritis. Materials and Methods: There were 61 cases of ankle arthritis treated by anterior or transfibular ankle arthrodesis in our hospital from April 2008 to March 2012. We investigated 29 cases (27 patients) who underwent ankle arthrodesis with an anterior approach (15 cases) and transfibular approach (14 cases), and were followed for over two years. Clinically, American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, pain visual analogue scale (VAS), and subjective satisfaction degrees were evaluated. In addition, ankle coronal and sagittal alignments were evaluated using plain radiographs at 6 and 24 months, postoperatively. Results: Clinically, preoperative mean AOFAS score and VAS was 41.3 and 6.4, and were changed to 58.9 and 3.3 postoperatively in the anterior approach group. In the transfibular approach group, preoperative mean AOFAS score was 36.6 and VAS was 7.1, and they were changed to 54.9 and 3.4 postoperatively. However, no significant differences in the clinical results were observed between the two groups (p=0.297). Duration of attaining union was 8.1 weeks in the anterior approach group and 10.4 weeks in the transfibular approach group. Complications were delayed union in one case, nonunion in three cases, cancellous screw breakage in three cases, and complex regional reflex syndrome in one case. Conclusion: After transfibular ankle arthrodesis as treatment of ankle osteoarthritis, the tendency for valgus angulation of the ankle at the final follow-up was observed and 6.5 mm cancellous screw breakage occurred frequently. Therefore, in order to achieve better stability, it is necessary to use 6.5 mm cannulated screws rather than 6.5 mm cancellous screws for ankle arthrodesis.

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References

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