Anterior Fusion Plate Research Articles

The Effects of Tibialis Anterior Tenotomy on Wound Problems after Anterior Fusion Plating for Severe Ankle Arthritis

Category: Ankle Arthritis; Ankle Introduction/Purpose: Because nonunion is known to be a relatively common complication following ankle arthrodesis, various fixation techniques have been introduced to enhance the stability and to improve fusion rate. With the use of anterior plate supplementation, postoperative wound problems have been frequently reported despite better fusion rate. This study was performed to determine the effects of tibialis anterior(TA) tenotomy on wound complications and functional outcomes after anterior fusion plating for severe ankle arthritis. Methods: Forty-six patients who underwent ankle arthrodesis using anterior fusion plate were followed for more than 3 years. TA tenotomy was performed prior to wound closure in all patients. As a control group, thirty-eight patients who underwent arthrodesis without TA tenotomy were analysed. Clinical outcomes were evaluated with Ankle Osteoarthritis Scale(AOS) and Foot and Ankle Ability Measure(FAAM). Wound complication rate, time to fusion, fusion rate, time to pain relief below 3 points in visual analog scale were evaluated. Results: Mean AOS and FAAM scores significantly improved to 32.6 and 69.4 points at final followup, respectively. As compared to control group (33.8 and 67.7 points), there were no significant differences in clinical outcomes. As postoperative wound complications, there were 1 case of wound dehiscence and 1 case of superficial wound infection. TA tenotomy group showed lower wound complication rate (4.3%) than control group (21.1%). While there were no significant differences in fusion rate, time to fusion, and time to pain relief between both groups, control group needed higher rate of implant removal. Conclusion: Ankle arthrodesis using anterior fusion plate in conjuction with TA tenotomy appears to be an effective surgical option for end-stage ankle arthritis, with higher fusion rate and less wound complication rate. Although there was no specific functional deficit related to a loss of the TA tendon, further studies are needed to determine the long-term effects of the TA tenotomy in patients with a fused ankle.

COMPARING OUTCOMES OF THE ANKLE ARTHRODESIS BY USING TWO DIFFERENT MATERIALS VIA A TRANSFIBULAR APPROACH.

ABSTRACTObjective: To compare clinical and radiologic results and complications of patients who underwent arthrodesis using a transfibular approach with either a cannulated screw or an anterior fusion plate.Methods: Patients who underwent ankle arthrodesis were divided into two groups according to the used materials: 6.5 mm cannulated screw (A) and anterior fusion plate (B). The clinical scores were compared between groups. The radiologic results were then assessed by union time. The results were statistically analyzed using SPSS 20.Results: There was no significant difference between both groups in the American Orthopedic Foot & Ankle Society (AOFAS) score (p = 0.75), and in the visual analog scale (p = 0.42). In group B, two cases included wound infection at the surgical site. In tt A, the mean union time was 10.5 ± 2.3 weeks. In group B, it was 7.8 ± 1.3. There was a statistically significant difference (p = 0.007) between union time in both groups.Conclusion: Anterior fusion plate is an effective method for shorter union time, but the surgeon should be careful with the surgical wound at the skin incision site in the lesion of the distal tibia. Level of Evidence III, Retrospective comparative study.