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The Journal of Bone and Joint Surgery, Vol 62, Issue 5 777-784, Copyright © 1980 by Journal of Bone and Joint Surgery, Inc
Complications and long-term results of ankle arthrodeses following trauma
BF Morrey and GP Wiedeman
A review of sixty patients who had undergone ankle fusion for
post-traumatic arthritis revealed that thirty-five (58 per cent) had the
procedure performed within the first year after injury. A total of
forty-eight complications occurred in twenty-nine (48 per cent) of the
patients. Frequent complication were infection (23 per cent), non-union (23
per cent), inadequate surgical alignment or early loss of position (15 per
cent), malunion (12 per cent), and delayed union (7 per cent). The lateral
transfibular approach had the highest incidence of complications, and a
two-incision approach using the Charnley compression apparatus was the
procedure with the fewest complications. Forty-one patients were followed
for an average of 7.5 years after operation. Of these, thirty-four (83 per
cent) were satisfied with the procedure. Examination of thirty of the
forty-one patients at an average of 7.3 years after surgery revealed
virtually no subtalar motion but motion of 13 degrees at Chopart's joint.
With shoes, patients had a near-normal gait. The roentgenograms revealed a
minimum amount of degenerative arthritis at Chopart's joint, which may
worsen with time. Varus or valgus angulation of the hind part of the foot
was associated with a greater degree of symptoms in the subtalar area as
well as the middle of the foot. The neutral position in varus-valgus
angulation as well as dorsiflexion-plantar flexion was the optimum position
for both men and women. The results of the procedure did not deteriorate
with time.
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