Paremain GD, Miller SD, Myerson MS

 

 

BACKGROUND: Of 34 ankle fusions (34 patients) performed at our institution between June 1992 and June 1993, 15 utilized a miniarthrotomy technique.

 

METHODS: This technique involves two 1.5-cm incisions, one medial and one anterolateral, through which the ankle joint cartilage and synovium are debrided. Subchondral bone resection is completed with a high-speed cutting tool, creating a “slurry” that is saved for local bone graft. The ankle is then appropriately positioned (5 degrees of valgus, 0 degree of dorsiflexion, and neutral rotation), cannulated screws are inserted, the position is checked fluoroscopically, and the wound is closed. The patient receives a short leg cast at 2 weeks and a walking cast at 3 to 5 weeks until there is radiographic and clinical evidence of solid arthrodesis.

 

RESULTS: In our 15 patients, follow-up ranged from 12 to 19 months after surgery and arthrodesis was radiographically evident at a mean of 6.0 weeks (range, 3-15 weeks). Complications were limited to a transient synovitis in 7/15 patients, which lasted approximately 3 weeks and was possibly related to the bone slurry.