Fibular Sparing Z-Osteotomy Technique for Ankle Arthrodesis

Glazebrook, Mark; Holden, Dean; Mayich, Joshua; Mitchell, Michael J.; Boyd, Gordon

doi:10.1097/btf.0b013e318199992a

Cited by 12 publications

(4 citation statements)

References 16 publications

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“…16 Thus, the best form of guiding the surgeon are the anatomical references. Although several studies show the functional results of the fixation technique with three screws 5,6,17,18 , we did not find studies on the anatomical population variation of the ankle and reference points that could be used by the surgeon for screw fixation and bone positioning. Our study showed a cheap and simple method of study with a group of individuals without anatomical anomalies to create a practical guide for positioning and fixation in ankle arthrodesis, using 3D reconstruction of scans.…”

Section: Introductionmentioning

confidence: 84%

“…4,5 Screw fixation is the most traditional method, usually made with two crossed screws, one with medial entry and the other with entry. 3,6,7 A third screw was generally added to the anteroposterior axis due to the high incidence of non-consolidations, usually with posterolateral entry into the tibia towards the neck of the talus, known as "home-run" screw ( Figures 1 and 2). [7][8][9][10] The screw is positioned to confront the strong deformation force of the Achilles tendon.…”

Section: Introductionmentioning

confidence: 99%

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Pre-Planning Ankle Arthrodesis Using 3d Reconstructed Tomographies

et al. 2020

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Objective: To implement one analysis method of the ankle bone contour that could make a more precise ankle arthrodesis. Methods: Twenty tomographies were submitted to 3D reconstruction. Seven points of anatomic interest for ankle arthrodesis with the three screws technique were marked with a triplannar marker. The median of the position of markers was estimated, and the union of the seven median points allow the construction of one median ankle for that population. Using this median ankle, sizes and angles for the screws position were determined. Results: Two median ankles were reconstructed, left and right. The position of the screw passage were determined considering the anatomical parameters. In the right ankle the lateral to medial screw should enter 4.56 cm and 0.79 above and posterior to lateral malleolus, with one inclination of 17.34° in relation to tibial longitudinal axis; and 0° in relation to tibial axial plane. The position for the other two screws is also described. Conclusion: Our article is the first to presents one precise guide for ankle arthrodesis based on a populational assessment. Level of evidence II, Diagnostic Studies.

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Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Pre-Planning Ankle Arthrodesis Using 3d Reconstructed Tomographies

et al. 2020

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“…Open ankle arthrodesis was performed through an anatomic transfibular approach that used a fibular-sparing z-osteotomy technique. 3 Arthroscopic ankle arthrodesis was performed through use of anteromedial and anterolateral portals and noninvasive distraction. A 4.0-mm arthroscope was used and joint surface prepared using a combination of shavers, burrs, and drills.…”

Section: Methodsmentioning

confidence: 99%

Preliminary Experience With SPECT/CT to Evaluate Periarticular Arthritis Progression and the Relationship With Clinical Outcome Following Ankle Arthrodesis

et al. 2020

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Background: Single photon emission computed tomography combined with computed tomography (SPECT/CT) could potentially aid in diagnosing periarticular arthritis/activity and progression, facilitate effective treatment options, and evaluate the effect surgery has on the clinical outcome of patients with ankle arthritis. The goal of our study was to assess SPECT/CT activity in the ankle and periarticular joints before and after ankle fusion surgery and determine whether it was associated with clinical pain and function scores. Methods: Thirty-four patients recruited into this study underwent either arthroscopic or open ankle fusion. X-ray (XR) and SPECT/CT imaging was obtained as well as completion of patient Ankle Osteoarthritis Scale (AOS) and 36-item Short Form Survey (SF-36) questionnaires preoperatively and at 6 months postoperatively. Ankle, subtalar, and talonavicular joint arthritis grading on XR and CT, along with SPECT/CT activity, was evaluated by 2 nuclear medicine radiologists. Data were assessed for normality and analyzed with the appropriate comparative test. P value was set at <.05. Thirty patients (31 ankles) completed follow-up and were analyzed. Results: SPECT/CT activity showed no significant difference in the ankle joint at 6 months postoperatively while periarticular joint activity significantly increased ( P < .05). Six months postoperatively, patients had significant improvements in their AOS and SF-36 scores ( P < .05). SPECT/CT grading of all joints analyzed, however, was not associated with AOS or SF-36 scores preoperatively or at 6 months postoperatively. Conclusion: In this study, intensity of activity as evaluated by SPECT/CT in periarticular hindfoot joints in patients who had ankle arthrodesis was not associated with clinical/functional scores at 6 months postoperatively. Level of Evidence: Level IV, diagnostic study.

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“…The results of that systematic review provide support for the surgical treatment of ESAA with arthrodesis, citing improvements in health-related quality of life, improvements in joint-specific clinical outcome scores, and acceptable complication rates.The most common surgical technique for arthrodesis of the ankle and other hindfoot joints is an open operative technique with rigid internal fixation. 15,20,21 This technique involves operative exposure of the joint to be fused, removal of remaining cartilage and subchondral bone from the arthritic joint surfaces, interposition of bone graft in gaps between the prepared joint surfaces, and anatomic reduction with compression of the joint surfaces using rigid internal fixation devices. Supplemental autogenous bone graft, placed between the joint surfaces to be fused, is commonly employed to decrease nonunion rates.…”

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confidence: 99%