Ankle arthrodesis using the cable technique.

OBJECTIVE

Arthrodesis of the ankle with a cable technique for restitution of pain-free gait with the foot in functional alignment.

INDICATIONS: Painful osteoarthritis of the ankle unresponsive to conservative and surgical treatment or in instances where these treatments do not seem sensible.

CONTRAINDICATIONS: Osteomyelitis, acute arthritis, neuropathic arthropathy.

SURGICAL TECHNIQUE: Exposure of the ankle through bilateral longitudinal incisions. Resection of malleoli and of articular surfaces of tibia and talus correcting at the same time any malalignment. Insertion of two cortical screws into the lateral aspect of the tibia and one each into talar body and neck. All four screws must protrude the opposite cortex. Around the neck of each anterior and posterior pair of screws as well as around the tips of the protruding screws cables are placed, tensioned, and tightened in a crimp.

RESULTS

An arthrodesis of the ankle was performed in 25 patients (25 ankles). The goal of surgery was reached in 21 patients at 6-8 weeks postoperatively. Two patients had to undergo a revision using the same method to secure a bony fusion. In another two the failure was due to a wrong indication; in both a bony fusion occurred after external fixation. Using the Mazur Score the patients reached an average of 74 points and with the MHH Score ("Medizinische Hochschule Hannover" [Hanover Medical School]) an average of 78 points, both attesting to a good result.