Document Detail


The use of circular wire external fixation in the treatment of salvage ankle arthrodesis.
MedLine Citation:
PMID:  15704079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The authors retrospectively reviewed their experience with circular wire external fixation in the treatment of salvage ankle arthrodesis during the past 9 years. The results of 43 cases in a difficult patient population are presented with an average follow-up of 27.0 months. Thirty-three patients (80.5%) went on to achieve a solid fusion or stable pseudarthrosis. A minimum of a 4-ring frame construct was applied for an average of 96.1 days. The major complication rate was 51.2%, including 3 below-knee amputations (7.3%), 7 unstable nonunions (17.1%), 7 cases of osteomyelitis and/or deep-space infection (16.3%), 3 malunions (7.3%), and 2 tibial stress fractures (4.7%). The incidence of complications occurred similarly in patients with Charcot arthropathy, failed total ankle arthroplasty, septic fusion, posttraumatic deformity, or avascular necrosis of the talus, whereas it was relatively higher in patients who were diabetics, smokers, or had an increased body mass index. In addition, the incidence of a nonunion tended to increase with longer follow-up, suggesting that early presumption of a solid union may be erroneous. Based on our defined criteria of a stable, well-aligned fusion without severe pain or activity restrictions, 28 patients (68.3%) had a good result. Circular wire external fixation can be a viable treatment for complex ankle salvage pathology; however, it is difficult to predict the prospects of success or failure.
Authors:
Eugene Zarutsky; Shannon M Rush; John M Schuberth
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons     Volume:  44     ISSN:  1067-2516     ISO Abbreviation:  J Foot Ankle Surg     Publication Date:    2005 Jan-Feb
Date Detail:
Created Date:  2005-02-10     Completed Date:  2005-06-23     Revised Date:  2006-04-20    
Medline Journal Info:
Nlm Unique ID:  9308427     Medline TA:  J Foot Ankle Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  22-31     Citation Subset:  IM    
Affiliation:
San Francisco Bay Area Foot and Ankle Residency Program, Kaiser Permanente Medical Center, San Francisco, CA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ankle Joint / surgery*
Arthrodesis / instrumentation,  methods*
Arthropathy, Neurogenic / surgery*
Bone Wires
External Fixators* / adverse effects
Female
Follow-Up Studies
Humans
Male
Middle Aged
Retrospective Studies
Salvage Therapy*
Treatment Outcome
Comments/Corrections
Comment In:
J Foot Ankle Surg. 2005 Sep-Oct;44(5):420; author reply 420-1   [PMID:  16210165 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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