Ankle joint arthrodesis with compression screws

The aim of the study was to assess distant results of treating ankle joint degenerative changes with low-invasive joint arthrodesis with screws compressing the joint ends. Material and methods. The material consisted of 24 patients - 13 women and 11 men - of the average age of 56.9. The observation period was on the average 9.1 years. The cause of degenerative lesions in 12 patients was an ankle fracture, in 3 - rheumatic arthritis, in 2 - a pilon fracture of the distal epiphysis of the tibial bone, a traumatic joint crush, chronic instability of the ankle joint, degenerative changes, and in 1 patient - degenerative changes occurring many years after a past gunshot wound of the ankle joint followed by inflammatory lesions. A surgical technique was applied that did not disturb the relationship between the talus and the tibial bone and did not cause a downward dislocation of the lateral ankle. A compression fixation of the joint was performed with 4 cancellous screws and allogeneic bone grafts. Results. In 19 patients, full radiological ankle joint arthrodesis was achieved. A good clinical result without pain complaints was obtained in 17 patients. 2 patients still complain of pain despite full joint arthrodesis. In 5 patients, there was no bone fusion at the site of arthrodesis. In 3 of them it was caused by talar necrosis, in 1 - a past infection, in 1 - destabilization of the fixation. Conclusions. Ankle joint arthrodesis is a good solution in advanced degenerative lesions of the joint. It relieves pain and only slightly reduces gait efficiency. Talar necrosis and destabilization of the fixation may be the causes of fusion failure after ankle joint fixation.