Arthroscopic ankle arthrodesis after tibial pilon open reduction internal fixation

Does Modified Footwear Improve Gait After Ankle Arthrodesis?

Rocker bottom shoes are commonly recommended for patients who have undergone ankle arthrodesis. Limited data are available to support this recommendation. In the present case-control study, 2 groups of participants were identified for the investigation: a study group (SG) of 9 patients who had previously undergone ankle arthrodesis and a normal group (NG) of 9 healthy volunteers. Gait data were collected using a video recorder while the participants walked barefoot and wearing rocker bottom shoes. These data were analyzed using computer-based gait analysis software. The total motion was calculated and averaged for each group for walking barefoot and wearing rocker bottom shoes. All participants completed the Short Musculoskeletal Function Assessment and the American Orthopaedic Foot and Ankle Society questionnaires. The total motion of the SG wearing rocker bottom shoes increased 4.8° (range 3.4° to 6.9°) on mean average, an improvement compared with walking barefoot (p < .05). In the NG, the shoe wear had no effect on the total motion (p = .59). Although the total motion in the SG approached the mean average of the total motion of the NG, it remained significantly less than that of the NG (p < .05). Additionally, the SG scored worse than the NG on both outcomes questionnaires (p < .05). Rocker bottom shoes had no effect on gait velocity. In conclusion, rocker bottom shoes significantly improve the total motion of ankle arthrodesis patients toward normal.

Tibiotalar arthrodesis in posttraumatic arthritis using the tension band technique

BACKGROUND

Although a variety of surgical techniques are available for the treatment of ankle degenerative disease, arthrodesis is a common treatment especially for unilateral posttraumatic arthritis in young patients. A clear trend toward internal fixation for ankle arthrodesis is evident, but fusion site compression is known to play an integral role in primary bone healing.

METHODS

Between September 2001 and October 2009, 17 adults with painful end-stage posttraumatic ankle arthritis were treated with the tension band technique to achieve tibiotalar arthrodesis.

RESULTS

Tibiotalar fusion was obtained in all patients at a mean of 16.6 (range, 13 to 28) weeks. No patient had pain at the last postoperative follow-up examination. AOFAS and Mazur scores were preoperatively 29 and 23.1, respectively, and postoperatively 71.1 and 70.7, respectively.

CONCLUSION

Arthrodesis with a tension band was a safe and effective surgical treatment option for posttraumatic ankle arthritis in patients without infection and good bone density, as it was simple, less invasive, and inexpensive and allowed early full weight-bearing.

LEVEL OF EVIDENCE

Level IV, retrospective case series.