Ankle Fusion: A New Technique of Internal Fixation Using a Compression Blade Plate

Abstract

A new technique of tibiotalar arthrodesis has been developed offering wide exposure, excellent correction of deformity, good bony apposition, and blade plate fixation. This technique has even been effective in cases of ischemic necrosis of the talus. A modified pediatric blade plate is used to effect compression of the talus to the tibia and to provide stability against flexion/extension and varus/valgus movement. Fixation is augmented by a lateral fibular strut screwed to the tibia and talus. In this series, 17 compression blade plate tibiotalar arthrodeses were performed. Follow-up averaged 48 months (range 13 to 85 months). Preoperative diagnoses included postraumatic degenerative arthritis, rheumatoid arthritis, and ischemic necrosis of the talus. Solid fusion was achieved in 16 of 17 patients (94%) with a painless, stable pseudarthrosis in the remaining one. Time to fusion averaged 4 months (range 2 ½ to 6 months). Functional clinical results were excellent in 12 and good in 4 patients. Of 14 patients evaluated by the Mazur scale, 10 scored within the range of excellent; 2, good; and 2, fair.