[Ankle arthrodesis by lateral malleolus osteotomy and internal fixation with locking proximal humeral plate].

Abstract

To summarize the surgical technique of ankle arthrodesis using lateral malleolus osteotomy and locking proximal humeral plate internal fixation, and to evaluate the clinical effectiveness.
Between March 2009 and June 2010, 18 patients with ankle joint disease were treated, including 8 cases of post-traumatic arthritis, 3 cases of rheumatoid arthritis, 5 cases of osteoarthritis, and 2 cases of post-traumatic necrosis of talus. There were 10 males and 8 females with an average age of 48 years (range, 36-67 years). The average disease duration was 3 years (range, 1-6 years). The main symptoms included swelling, pain, and a limited range of motion of the ankle. Four patients accompanied with ankle varus deformity and 2 patients with valgus deformity. According to American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score system, the preoperative score was 43.5 +/- 10.2. An ankle arthrodesis using lateral malleolus osteotomy and locking proximal humeral plate internal fixation was performed in all patients.
Superficial wound infection and partial skin necrosis occurred in 1 case respectively, and were cured after symptomatic treatment; the other incisions healed by first intention without complications. Sixteen patients were followed up 16 months on average (range, 1-2 years). The X-ray films showed that bone fusion was obtained at 8-16 weeks (mean, 12 weeks) after operation. The symptom was relieved completely in all patients at last follow-up without complication of implant failure, nonunion, and malunion. The postoperative AOFAS ankle and hindfoot score was 83.0 +/- 6.3, showing significant difference when compared with the preoperative score (t=26.20, P=0.00).
Ankle arthrodesis using lateral malleolus osteotomy and locking proximal humeral plate internal fixation has the advantages of feasible technique, the rigid fixation, and high fusion rate, so it may obtain a good clinical effectiveness.