Duke Whan Chung; Jae Hoon Lee; Bi O Jeong; Keun Ho Park

doi:10.4055/jkoa.2009.44.2.165

Journal List > J Korean Orthop Assoc > v.44(2) > 1012884

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Chung, Lee, Jeong, and Park: Ankle Arthrodesis with using Variable Pitch Tapered Screws (Acutrak® Screw) Fixation

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2009; 44(2): 165-169.

Published online: 30 April 2009

DOI: https://doi.org/10.4055/jkoa.2009.44.2.165

Ankle Arthrodesis with using Variable Pitch Tapered Screws (Acutrak® Screw) Fixation

Duke Whan Chung, M.D., Jae Hoon Lee, M.D., Bi O Jeong, M.D., Keun Ho Park, M.D.

Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, Seoul, Korea.

Address reprint requests to Bi O Jeong, M.D. Department of Orthopaedic Surgery, School of Medicine, Kyung Hee University, 1, Hoeki-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: +82.2-958-9488, Fax: +82.2-964-3865, biojeong@khmc.or.kr

Abstract

Purpose

The purpose of this study was to evaluate the clinical and radiologic results of open arthrodesis with using variable pitch tapered screws (Acutrak® screw) for treating ankle arthritis.

Materials and Methods

The subjects were 14 patients with 16 cases of performing ankle arthrodesis with using variable pitch tapered screws. Clinical evaluation was performed with using the American Orthopaedic Foot and Ankle Society ankle-hindfoot functional scale and the visual analogue scale pain score, and we assessed the postoperative complications and the patient's satisfaction. Radiological evaluation was performed by the assessing the time to union, the position of union, and the degenerative changes of the adjacent joints of the foot.

Results

The average follow-up period was 15 months. The ankle-hindfoot functional scale was improved from an average of 38.9 points (range: 27-57 points) preoperatively to an average of 77.3 points (range: 66-89 points) at the last follow up. The visual analogue scale pain score was decreased from an average of 7.9 (range: 3-10) to 2.9 (range: 0-5), and 13 cases (81%) were satisfied with the outcome of surgery. For all the cases, radiological union was obtained at an average of 11.2 weeks (range: 6-16 weeks).

Conclusion

We performed arthrodesis with using variable pitch tapered screws for treating ankle arthritis, and satisfactory short term results were obtained both clinically and radiologically.

Keywords: Ankle joint, Arthritis, Ankle fusion

Figures and Tables

Fig. 1

(A) Ankle anteriorposterior and lateral radiography of 66 years old female with primary osteoarthritis. (B) Ankle arthrodesis with transarticular crossed screw fixation performed. At postoperative 10 weeks, ankle radiography showed fusion of ankle.

Fig. 2

(A) Another radiography of ankle of 55 years old male with end stage primary osteoarthritis. (B) Radiographs taken 18 weeks after ankle arthrodesis showed solid fusion of the ankle.

Table 1

Etiology of Ankle Fusion

Table 2

Clinical Results of Ankle Fusion

^*AOFAS, American Orthopedic Foot and Ankle Society.

Table 3

The Position of the Ankle before and after Arthrodesis

References

1. Ahlberg A, Henricsion AS. Late results of ankle fusion. Acta Orthop Scand. 1981. 52:103–105.

2. Anderson T, Montgomery F, Besjakov J, Verdier H, Carlson A. Arthrodesis of the ankle for non-inflammatory conditions: healing and reliability of outcome measurements. Foot Ankle Int. 2002. 23:390–393.

3. Boobbyer GN. The long term results of ankle arthrodesis. Acta Orthop Scand. 1981. 52:107–110.

4. Buchner M, Sabo D. Ankle fusion attributable to posttraumatic arthrosis: a long-term followup of 48 patients. Clin Orthop Relat Res. 2003. 406:155–164.

5. Buck P, Morrey BF, Chao EY. The optimum position of arthrodesis of the ankle. A gait study of the knee and ankle. J Bone Joint Surg Am. 1987. 69:1052–1062.

6. Charnley J. Compression arthrodesis of the ankle and shoulder. J Bone Joint Surg Br. 1951. 33:180–191.

7. Chuninard EG, Peterson RE. Distraction-compression bone-graft arthrodesis of the ankle. A method especially applicable in children. J Bone Joint Surg Am. 1963. 45:481–490.

8. Coester LM, Saltzman CL, Leupold J, Pontarelli W. Long-term results following ankle arthrodesis for post-traumatic arthritis. J Bone Joint Surg Am. 2001. 83:219–228.

9. Dereymaeker GP, Van Eygen P, Driesen R, De Ferm A. Tibiotalar arthrodesis in the rheumatoid foot. Clin Orthop Relat Res. 1998. 349:43–47.

10. Holt ES, Hansen ST, Mayo KA, Sangeorzan BJ. Ankle arthrodesis using internal fixation. Clin Orhop Relat Res. 1981. 268:21–28.

11. Kitaoka HB, Alexander IJ, Adelaar RS, Nunley JA, Myerson MS, Sanders M. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994. 15:349–353.

12. Levine SE, Myerson MS, Lucas P, Schon LC. Salvage of pseudoarthrosis after tibiotalar arthrodesis. Foot Ankle Int. 1997. 18:580–585.

13. Mann RA, Rongstad KM. Arthrodesis of the ankle: a critical analysis. Foot Ankle Int. 1998. 19:3–9.

14. Mann RA, Van Manen JW, Wapner K, Martin J. Ankle fusion. Clin Orthop Relat Res. 1991. 268:49–55.

15. Maurer RC, Climino WR, Cox CV, Satow GK. Transarticular cross-screw fixation: a technique of ankle arthrodesis. Clin Orthop Relat Res. 1991. 268:56–64.

16. Muir DC, Amendola A, Saltzman CL. Long-term outcome of ankle arthrodesis. Foot Ankle Clin. 2002. 7:703–708.

17. Rockett MS, Ng A, Guimet M. Posttraumatic ankle arthrosis. Clin Podiatr Med Surg. 2001. 18:515–535.

18. Stranks GJ, Cecil T, Jeffery IT. Anterior ankle arthrodesis with cross screw fixation. A dowel graft method used in 20 cases. J Bone Joint Surg Br. 1994. 76:943–946.

19. Wheeler DL, McLoughlin SW. Biomechanical assesment of compression screws. Clin Orthop Relat Res. 1998. 350:237–245.

TOOLS

Similar articles