Ankle arthrodesis from lateral transfibular approach: analysis of treatment results of 23 feet treated by the modified Mann’s technique

Napiontek, Marek; Jaszczak, Tomasz

doi:10.1007/s00590-015-1663-9

Cited by 19 publications

(10 citation statements)

References 8 publications

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“…Screw fixation is most frequently used for internal fixation due to its high stability, maintenance of the normal shape of the ankle joint, and preservation of the equal length of lower limbs 7 . In the published literature, arthrodesis through the trainsfibular approach has demonstrated satisfactory bone fusion rates 13,14,17,[23][24][25][26] (Table 5). In the present study, two or three 7.3 × 60 mm headless compression full-threaded cannulated screws were used to cross-fix the tibiotalar joint, and three or four 3.5 × 34 mm cortical screws were used to fix the fibula to the tibia and talus.…”

Section: Screw Fixationmentioning

confidence: 99%

End‐stage Ankle Arthritis Treated by Ankle Arthrodesis with Screw Fixation Through the Transfibular Approach: A Retrospective Analysis

Suo

Liang

et al. 2020

Orthopaedic Surgery

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Objective To evaluate the clinical outcome of ankle arthrodesis with screw fixation through the transfibular approach for end‐stage ankle arthritis. Methods Data of 22 patients (28 ankles) with end‐stage ankle arthritis admitted to the Department of Orthopedics and Surgery of the First Hospital of Jilin University from May 2015 to December 2018 were analyzed retrospectively. The study included 9 men and 13 women, with a mean age of 56.86 ± 11.27 years (range, 37–75 years). The mean duration of the disease was 11.36 ± 12.80 years (range, 3 months‐50 years). A total of 16 patients had posttraumatic arthritis, 5 patients had osteoarthritis, and 1 patient had rheumatoid arthritis. There were 12 cases of the left ankle and 16 cases of the right ankle; 16 cases were unilateral and 6 were bilateral. The same surgical procedure was applied to all patients. Collected data included the operation time, intraoperative and postoperative blood loss, hospitalization time, bone union rate, time to bone union, and complications. The American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot score and the visual analogue scale (VAS) were used to evaluate the preoperative status and the postoperative outcome at the last follow up. Results The mean follow‐up period was 26.14 ± 10.99 months. The mean operation time was 101.82 ± 33.33 min. The mean blood loss was 116.78 ± 68.86 mL during the procedure and 111.07 ± 52.18 mL after the procedure. The mean hospitalization time was 14.22 ± 5.42 days. Bone union of the ankle joint was achieved in all patients. The mean time to bone union was 14.83 ± 2.14 weeks. There was significant difference in the operation time between the patients undergoing unilateral and bilateral ankle arthrodesis. The AOFAS ankle hindfoot score increased from the preoperative value of 43.46 ± 4.39 points to 80.39 ± 5.37 points at the last follow up. During the same interval, the VAS score improved from 6.14 ± 0.80 points to 1.64 ± 0.73 points. The AOFAS ankle hindfoot score of patients who underwent unilateral ankle arthrodesis improved from the preoperative 43.19 ± 3.95 points to 81.75 ± 5.23 points at the last follow up, and the VAS score improved from 6.19 ± 0.83 points to 1.69 ± 0.70 points. The AOFAS ankle hindfoot score of patients undergoing bilateral ankle arthrodesis improved from the preoperative value of 43.83 ± 5.08 points to 78.67 ± 5.05 points at the last follow up, while the VAS score improved from 6.08 ± 0.82 points to 1.58 ± 0.79 points. There was significant difference in the maximum walking distance and walking on any surface between the patients undergoing unilateral and bilateral ankle arthrodesis. One patient developed superficial peroneal nerve palsy, which resolved within 1 year after the operation. In another patient, healing of the incision skin was delayed. During the follow‐up period, none of the patients developed an infection of the incision or local skin necrosis; screw loosening, withdrawal, or breakage did not occur in any patient. Conclusion The ankle arthrodesis with screw ...

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Section: Screw Fixationmentioning

confidence: 99%

End‐stage Ankle Arthritis Treated by Ankle Arthrodesis with Screw Fixation Through the Transfibular Approach: A Retrospective Analysis

Suo

Liang

et al. 2020

Orthopaedic Surgery

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“…Napiontek M [23], Mann RA et al [24], with the best advantage of fully exposing the articular surface of the ankle. Inspired by this approach, we tried to apply a novel approach similar to it, the bular notch approach introduced in the present study, for the treatment of some speci c…”

Section: Discussionmentioning

confidence: 99%

A Fibular Notch Approach for the Treatment of Ankle Fractures Involving the Distal Tibial Plafond

Liu

Cheng

2020

Preprint

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BACKGROUND: Although several approaches have been used for the treatment of complex ankle fractures, there are still some ankle fractures which can not obtain ideal intraoperative exposure with these traditional approaches. The purpose of this study was to present an innovative fibular notch approach in detail for the treatment of ankle fractures involving the distal tibial plafond and to present a series of patients with either functional or radiographic outcomes.METHODS: Between March 2015 and October 2018, 22 patients with distal tibial plafond fractures with concomitant fibular and distal tibiofibular syndesmosis injuries were treated through a fibular notch approach. The details of the surgical technique were reviewed from the operative notes. Relevant data were reviewed from the medical records. The quality of fractures and syndesmosis reduction was examined using CT scans, and lateral stability of the ankle was assessed by physical examination and stress radiographs. The American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS) score was implemented for clinical functional assessment.RESULTS: All surgeries were successfully performed via the fibular notch approach as the primary approach. Postoperative radiography revealed satisfying restoration of all fractures and syndesmosis; however, CT scans showed mild malreduction with a gap of less than 2 mm in 4 fractures and a step-off of less than 2 mm in 1 fracture. No significant soft tissue complications occurred except for one case of delayed wound healing. All fractures healed with an average time of 17.3±3.6 weeks. Mild posttraumatic osteoarthritis (PTOA) was present in 4 patients. All patients achieved lateral stability of the ankle except one patient with distal syndesmosis instability. The average ankle range of motion was 55.0 degrees. The average AOFAS score was 88.8.CONCLUSIONS: The fibular notch approach is a safe and reliable approach for the treatment of specific ankle fractures involving the distal tibial plafond. This approach provides excellent direct visualization of the fragments and articular surface without significantly increasing iatrogenic injuries. Satisfactory radiographic and clinical results were observed, and further clinical and anatomical studies are recommended to ascertain the feasibility of this approach in the treatment of complex distal tibial fractures.

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“…This technique has evolved for several decades and included the using lateral malleolus as a graft source, a change in the number of implants used in tibiotalar stabilization, and a variation in the direction of screw insertion. Additionally, anterior, posterior and medial transmaleollar approaches have been described [32]. Currently, an anatomic ankle fusion with fibular-sparing technique is widely utilized as it offers several advantages.…”

Section: Arthrodesismentioning

confidence: 99%

Imaging and Treatment of Posttraumatic Ankle and Hindfoot Osteoarthritis

Gorbachova

Melenevsky

Latt

et al. 2021

JCM

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Posttraumatic osteoarthritis of the ankle and hindfoot is a common and frequently debilitating disorder. 70% to 90% of ankle osteoarthritis is related to prior trauma that encompasses a spectrum of disorders including fractures and ligamentous injuries that either disrupt the articular surface or result in instability of the joint. In addition to clinical evaluation, imaging plays a substantial role in the treatment planning of posttraumatic ankle and hindfoot osteoarthritis. Imaging evaluation must be tailored to specific clinical scenarios and includes weight bearing radiography that utilizes standard and specialty views, computed tomography which can be performed with a standard or a weight bearing technique, magnetic resonance imaging, and ultrasound evaluation. This review article aims to familiarize the reader with treatment rationale, to provide a brief review of surgical techniques and to illustrate expected imaging appearances of common operative procedures performed in the setting of posttraumatic ankle and hindfoot osteoarthritis, such as joint-preserving procedures, ankle fusion, subtalar fusion, tibiotalarcalcaneal fusion and ankle arthroplasty. Preoperative findings will be discussed along with the expected postoperative appearance of various procedures in order to improve detection of their complications on imaging and to provide optimal patient care.

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Ankle arthrodesis from lateral transfibular approach: analysis of treatment results of 23 feet treated by the modified Mann’s technique

Abstract: The study has confirmed the effectiveness of the technique.

Cited by 19 publications

References 8 publications

End‐stage Ankle Arthritis Treated by Ankle Arthrodesis with Screw Fixation Through the Transfibular Approach: A Retrospective Analysis

End‐stage Ankle Arthritis Treated by Ankle Arthrodesis with Screw Fixation Through the Transfibular Approach: A Retrospective Analysis

A Fibular Notch Approach for the Treatment of Ankle Fractures Involving the Distal Tibial Plafond

Imaging and Treatment of Posttraumatic Ankle and Hindfoot Osteoarthritis

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