Clinical Research On Application Of Reconstruction Plate For Arthrodesis Of The Ankle Via Anterior Approach

Objective:To introduce a new technique of ankle arthrodesis with reconstruction plate via anterior approach and evaluate its clinical effects.Methods:From April 2005 to September 2009,ankle arthrodesis with reconstruction plate was performed in 20 patients with serious lesions,including 13 right foot cases and 7 left foot cases.There were 10 males and 10 females with an average age of 51 years (range from 24 to 75 years).The diagnoses included post-traumatic arthritis in 15 cases and degenerative osteoarthritis in 5 cases.Anterior incision was adopted and from the edge of the medial tibial cutting periosteum and joint capsule,revealing the ankle joint.Fixed reconstruction plate in flexion 0°,valgus 5°-10°.external rotation 5°-10°and backward displacement of talus slightly,using iliac bone graft.Long-leg cast was fixed 4 weeks postoperatively to maintain a functional position,and a further fixation of short-leg walking-cast was utilized for 6 weeks.Results:All the 20 cases were available for review,with an average follow-up of 30 months(range from 6 months to 4 years).There were no severe complications,only one case suffered from little pain and two cases suffered from slightly swelling and complained of local discomfort after long time of walking or standing,but it did not affect their daily lives.AOFAS clinical rating system score increased from 24.95 preoperatively to 87.45 postoperatively and each item including pain,function and alignment were all improved significantly.Sufficient pain relief was obtained in all patients and appearance greatly improved.A solid union was achieved in all cases from the radiograph. Conclusions:The use of reconstruction plate in ankle fusion by anterior approach was proved to be a simple technique with higher union rate,fewer complications and enough bone graft.