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The Effect of Screw Position and Number on the Time to Union of Arthroscopic Ankle Arthrodesis.
MedLine Citation:
PMID:  23089350     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: This study aimed to investigate the factors that influence the time to union after arthroscopic ankle arthrodesis. METHODS: From June 2005 to October 2010, 46 patients (50 ankles) underwent arthroscopic ankle arthrodesis with 6.0-mm cannulated cancellous screws. There were 22 men and 24 women (mean age, 63 years). Medical records and radiographs were retrospectively reviewed. Screw configurations used were as follows: 3 transmedial and translateral malleolar screws (ML3) in 12 ankles (24%), 2 transmedial and translateral malleolar screws (ML2) in 4 ankles (8%), 3 transmedial malleolar screws (M3) in 23 ankles (46%), and 2 transmedial malleolar screws (M2) in 11 ankles (22%). RESULTS: Radiographic fusion was achieved in 46 (92%) of the 50 ankles. The mean time to fusion was 11.0 ± 4.5 weeks for ML3, 13.1 ± 3.3 weeks for ML2, 9.7 ± 2.7 weeks for M3, and 12.5 ± 3.5 weeks for M2 (P < .05). The mean American Orthopaedic Foot & Ankle Society scores were 81.3 ± 2.2 for ML3, 83.5 ± 4.4 for ML2, 88.3 ± 1.5 for M3, and 85.3 ± 2.2 for M2. The mean time until radiographic fusion was 10.2 ± 3.4 weeks for correction angles of less than 10° and 13.2 ± 3.4 weeks for angles of 10° or greater (P < .01). In obese patients a significant difference in ankle fusion time was observed (12.6 ± 3.5 weeks for patients with body mass index ≥25 v 9.4 ± 2.9 weeks for patients with body mass index <25, P < .01). CONCLUSIONS: Overall, this study showed that arthroscopic ankle arthrodesis achieves a high rate of union, with fastest union achieved with 3 parallel screws placed medially from the distal tibia into the talus. Care should be taken when one is designing treatment strategies for obese patients and/or patients with large correction angles. LEVEL OF EVIDENCE: Level IV, retrospective case series.
Authors:
Ichiro Yoshimura; Kazuki Kanazawa; Akinori Takeyama; Takahiro Ida; Tomonobu Hagio; Chayanin Angthong; Masatoshi Naito
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-20
Journal Detail:
Title:  Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association     Volume:  -     ISSN:  1526-3231     ISO Abbreviation:  Arthroscopy     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506498     Medline TA:  Arthroscopy     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan. Electronic address: ichiroy@cis.fukuoka-u.ac.jp.
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