Comparative study of midterm results of a modified technique for ankle fusion versus an anterior T plate

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Abstract

Introduction
Although many techniques are available to fuse the ankle, current recommendations favor the use of internal fixation with screws and/or plates. Despite the progress, the complication rate remains a major concern. This study is a prospective case series study that was carried out to assess the functional outcome of open ankle fusion using two different techniques: modified compression and sliding graft, and an anterior AO T plate.
Patients and methods
Between June 2004 and November 2007, 22 tibiotalar arthrodesis by the modified compression fixation and sliding graft technique were performed (group A), and an anterior T plate (group B); each group included 11 patients. The average age of the patients in group A was 32.9 years (26–53), whereas in group B, it was 32 years (25–54). There were 18 men and four women. Among these, 18 patients had post-traumatic arthritis, three had primary osteoarthrosis, and one had sciatic nerve injury.
Results
A rate of fusion achieved was 100 and 91% (groups A and B, respectively). Patients with a minimum follow-up period of 32 months after the arthrodesis were analyzed. The average follow-up period was 42 months (range, 32–58 months). Tibiotalar fusion was achieved in all the ankles at an average of 13 weeks (range, 10–19 weeks), 14.6 weeks (range, 13–21 weeks) (groups A and B, respectively).
Conclusion
Although arthrodesis of the ankle that uses lag screws for internal fixation is a safe and biomechanically stable method to obtain a solid ankle fusion and yields excellent results in most patients, there were no significant differences between both techniques of ankle fusion.

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