Open Ankle Arthrodesis: Transfibular Approach

摘要

Ankle arthrodesis is a well-established surgical treatment for patients suffering from end-stage ankle osteoarthritis. This procedure can be executed by surgeons through various techniques. Among these methods is the open transfibular approach, which is utilized by the senior author as a routine procedure to treat the degenerative articulation. Outcomes of primary open ankle arthrodesis operations and cases necessitating a revision following a primary procedure were assessed through retrospective data and collective experience and were found to be similar to comparable postoperative complication rates. Level of Evidence: Diagnostic Level IV. See Instructions for Authors for a complete description of levels of evidence. The incidence of ankle osteoarthritis (OA) is growing in health care with an estimation of 100,000 new cases annually. Consequently, the associated financial burden of treatment for this disorder is in excess of 3 billion dollars. Additional to the financial setbacks, this condition, especially in end-stage severity, results in a substantially decreased quality of life and significant functional deficiencies. These impairments have been found to be equal in severity to those related to disorders such as end-stage kidney disease, congestive heart failure, and end-stage hip osteoarthritis. Among various causative factors, the most common etiology for ankle OA is a posttraumatic manifestation, which has been reported to constitute 71% to 78% of all cases. Posttraumatic osteoarthritis often affects younger patients and commonly presents with concomitant hindfoot deformities. The general treatment principles include pain reduction and restoring the function of the hindfoot. Initial conservative treatment may include medication, bracing, joint injection, shoe modification, and mechanical unloading. Surgical intervention should be reserved for the patients whose symptoms are not adequately resolved following conservative treatment. In those particular cases, stage adapted treatment of ankle OA surgically consists of debridement via arthroscopy or open arthrotomy, distraction arthroplasty, osteochondral ankle joint resurfacing, corrective osteotomies, ankle arthrodesis, and total ankle replacement.