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At least 19 recordsLinked to original sources
PubMed1999

Ankle arthrodesis: internal non-compression arthrodesis versus internal compression arthrodesis.

Ankle arthrodesis is still considered to be the standard treatment for most disabling types of ankle arthritis, but fusion methods are varied. We report our experience of ankle arthrodesis and compare a group of 34 cases treated by Blair's non-compression arthrodesis to another group of 32 cases treated by internal compression arthrodesis using two crossed screws. The same surgeon performed all the operations. The Blair's non-compression arthrodesis group included 21 males and 13 females with an average age of 42 y/o (range 18-70 y/o) and an average follow up period of 38.6 months (range 26-62 months). The union rate was 91.2% and the average union time was 5.6 months (range 2-10 months). There were three cases of non-union. The cross-screw compression arthrodesis group included 20 males and 12 females with an average age of 45 y/o (range 20-86 y/o) and an average follow up period of 38.3 months (range 15-81 months). The union rate was 96.9% and the average union time was 2.7 months (range 1.5-4.4 months). There was one case of non-union. We conclude that our cross-screws compression arthrodesis with its shorter fusion time was found to be superior to the Blair's non-compression arthrodesis.

Adult↗
PubMed2000

The results of a primary and staged pantalar arthrodesis and tibiotalocalcaneal arthrodesis in adult patients.

Twenty-three patients (twenty-seven feet) with either a primary or staged pantalar arthrodesis or a tibiotalocalcaneal arthrodesis were evaluated to determine their clinical status. The main indication for the operation was the presence of severe pain unresponsive to non-operative treatment. Fourteen feet (twelve patients) had a pantalar arthrodesis; a fusion of the ankle, subtalar, talonavicular and calcaneocuboid joints. Half the feet in this group had either a triple arthrodesis or an ankle fusion performed at an earlier time. The remaining seven feet had all joints fused during the same operation. Thirteen feet (eleven patients) had a tibiotalocalcaneal arthrodesis. Two of these feet had an ankle arthrodesis performed four and six years previously. The other eleven had the ankle and subtalar joints fused during the same operation. All patients were followed for a mean of fifty-five months (14 to 159 months) from the time of their final arthrodesis procedure. Overall, twenty-three of the twenty-seven feet achieved a solid arthrodesis of all joints operated upon. Four feet had a failure of fusion of only a single joint and all were in the pantalar group. The mean time to radiographic fusion was twenty-three weeks and resulted in a plantigrade foot with an average tibia-floor angle of 87 degrees. Complications occurred in ten feet (37%); of which there were three deep infections; two ankles and one subtalar joint. These arthrodeses procedures resulted in marked relief of the patients' preoperative pain, the main indication for performing the surgery. Postoperatively there was no pain in eleven feet, mild occasional pain in thirteen feet, and moderate pain in only three feet. However, when all parameters of our clinical rating scale were evaluated, only five patients had an excellent clinical result, nine were rated good, three were rated fair and six patients had a poor result. These operations must be considered to be salvage procedures. They are technically difficult to perform and major complications may occur. Pain relief appears to be the main indication for performing these operations, and may account for whatever improvement occurs in the patient's function.

Adult↗
PubMed2026

Early radiographic loss of intermetatarsal angle correction after single first TMT arthrodesis (Modified Lapidus) versus three-corner TMT arthrodesis.

INTRODUCTION: The Lapidus procedure treats hallux valgus with first-ray hypermobility. It can be performed as a single first tarsometatarsal (TMT) arthrodesis or a three-corner TMT construct with additional intermetatarsal fusion. Early loss of correction remains a concern. This study compared early radiographic stability between techniques. METHODS: Fifty patients (15 three-corner TMT arthrodesis, 35 single first TMT arthrodesis) treated between 2014 and 2023 were retrospectively reviewed. Hallux valgus angle (HVA), intermetatarsal angle (IMA), Méary's angle, and tibial sesamoid position were measured on weight-bearing radiographs at 6 weeks and 6 months postoperatively. RESULTS: Both techniques achieved significant correction. The three-corner TMT arthrodesis group showed greater initial IMA correction at 6 weeks (p = 0.020) and maintained a lower IMA at 6 months (p = 0.001). Early IMA loss was greater after single first TMT arthrodesis (1.5°±1.7° vs 0.6°±0.8°, p = 0.013). CONCLUSION: Three-corner TMT arthrodesis was associated with greater early intermetatarsal stability than single first TMT arthrodesis.

Humans↗
PubMed1999

Comparison of open isolated subtalar arthrodesis with autogenous bone graft versus outpatient arthroscopic subtalar arthrodesis using injectable bone morphogenic protein-enhanced graft.

Isolated subtalar joint arthrodesis is an established salvage procedure that can be performed in various ways for varying diagnoses. The purpose of this article is to report a new arthroscopic subtalar arthrodesis technique that has been developed. The results of this method versus an open technique were compared. Length of hospital stay, tourniquet time, morbidity, and fusion rate were studied in 17 fusion patients between 1990 and 1997. Twelve patients had open arthrodesis with bone graft and 5 patients had arthroscopic arthrodesis with supplemental, injectable, osteoinductive enhanced-graft gel. The length of stay decreased 1.7 days with the arthroscopic procedure. Tourniquet time was not significantly different. One open procedure required refusion, whereas none did in the arthroscopic group. One patient in each group required AO screw removal. In selected patients with subtalar arthrosis without significant hindfoot deformity, arthroscopic arthrodesis can be an effective. It is too early to determine if there are specific advantages in this procedure compared with a conventional open arthrodesis.

Adolescent↗
PubMed2002

AO-wrist arthrodesis: with and without arthrodesis of the third carpometacarpal joint.

The incorporation of the third carpometacarpal joint (CMCJ-3) during wrist arthrodesis is controversial. This retrospective study of 146 consecutive wrist arthrodeses with AO plate fixation specifically addresses this question. In 79 wrist arthrodeses the CMCJ-3 was also arthrodesed, and in 67 the CMCJ-3 was simply bridged. Problems relating specifically to the CMCJ-3 could not be analyzed clearly with the plate in situ. Therefore after plate removal only 81 wrists were evaluated with respect to the CMCJ-3. Of 47 wrists that had CMCJ-3 arthrodesis and plate removal, 20 developed a nonunion. Eleven of these were painful and further surgical treatment was required. In contrast, of 34 wrists with the CMCJ-3 bridged all but one remained free of symptoms after the plate had been removed. We conclude that the CMCJ-3 must not be included in the arthrodesis when performing an AO-wrist arthrodesis.

Adolescent↗
PubMed1993

[Arthrodesis of the ankle joint: effect of the position of the arthrodesis on the foot. Apropos of a series of 50 cases reviewed with an average follow-up of 9 years].

UNLABELLED: A functional assessment of fifty patients after ankle arthrodesis for post traumatic arthritis was carried out by means of an extensive clinical evaluation after an average follow-up of nine years. The data on position of ankle arthrodesis and gait analysis were examined to determine the effect of arthrodesis of the ankle on the subtalar and small joints of the foot. The Duquennoy point system was used to grade the ankle clinically and a new radiological method to determine the sagittal position of the ankle arthrodesis was developed. Equinus position was related with clinical damage on sub talar joint, and anterior cavus foot (92.8 per cent). This position was related with metatarsalgia in 26.9 per cent. Calcaneus position was related with posterior cavus foot (verticalization of the calcaneus). This position was related with the best functional results on walking, jumping and running. CLINICAL RELEVANCE: this study has showed that the ideal position of fusion of the ankle was neutral or slight flexion, slight valgus angulation of the hind part of the foot and 10 degrees of external rotation.

Adult↗
PubMed1984

Capitate-radius arthrodesis: an alternative method of radiocarpal arthrodesis.

Arthrodesis of the wrist may be indicated for a variety of conditions and can be achieved by many techniques. We have had experience with radiocarpal arthrodesis by fusion of the capitate to the radius after a modified proximal row carpectomy . The common feature in our 10 patients was a flexion deformity of the wrist. In five of the patients it was the result of spastic posturing. Five of the patients had a variety of other conditions. Primary arthrodesis occurred in all patients and the cosmetic improvement was appreciated by all patients. Functional improvement seemed to be most related to the preoperative condition. The follow-up evaluation averaged 5.4 years with a range from 6 months to 11 years.

Adolescent↗
PubMed1995

Arthrodesis after infected knee arthroplasty using long arthrodesis nail. A report of five cases.

Safe methods to perform secondary arthrodesis in the treatment of infected total knee arthroplasty (TKA) after revision arthroplasty has failed are increasingly needed as TKA becomes more common. Possible treatments include external fixation (with single- or double-framed fixators), internal fixation, or amputation. This article reports five cases of infected TKA treated with arthrodesis using a long intramedullary nail. Arthrodesis was performed in a two-stage manner, with surgical revision and insertion of a long intramedullary nail. All arthrodeses healed on an average of 4.8 months.

Adult↗
PubMed1988

Failed arthrodesis of the spine for severe spondylolisthesis. Salvage by interbody arthrodesis.

Four patients who had had grade-III or grade-IV symptomatic spondylolisthesis and a failed posterior or posterolateral arthrodesis were treated with transperitoneal anterior lumbosacral interbody arthrodesis and fixation with a fibular graft; the procedure was sometimes followed by posterolateral arthrodesis of the spine. The patients were examined ten to twenty-two years after the salvage operation. At follow-up, all had a solid fusion of the fifth lumbar to the first sacral vertebra. No neurological deficits had worsened and no iatrogenic neurological deficits had developed. The slip angle had improved by an average of 23.2 degrees (range, 12 to 35 degrees).

Adolescent↗
PubMed1980

Triple arthrodesis and Lambrinudi arthrodesis. Literature review and follow-up study.

A literature review is presented about triple arthrodesis and Lambrinudi arthrodesis including indications, techniques, complications, and a more extensive review of some specific indications. Forty-eight patients were operated on between 1961 and 1977, 25 of whom were reviewed at follow-up. Our follow-up study shows a rather high rate of pseudarthrosis, with however a normal failure rate. According to these findings transfixation of the bones with K-wires is to be considered.

Adolescent↗
PubMed1999

[Arthrodesis - non-union of the ankle. Arthrodesis failed].

Non-unions after fracture dislocation of the ankle joint are extremely rare with predominantly operative treatment. In contrast, after fractures of the tibial plafond (pilon fractures) infections are seen in the literature in 37 % and non-unions are seen in 27 % after open reduction and internal fixation, requiring secondary ankle arthrodesis in about one quarter of all cases. In contrast to aseptic non-union or arthrosis, which can be salvaged with screw arthrodesis, with prevailing infection and severe osteoporosis external fixation (either one- or two-sided) is the treatment of choice. In isolated non-unions of the malleoli, either plate osteosynthesis with 3.5 low-contact dynamic compression plate or tension banding with autologous bone graft interposition, or alternatively sliding graft technique, is performed with good results.

Ankle Injuries↗
PubMed2002

Arthrodesis by percutaneous fixation: patellofemoral arthrodesis in rabbits without debridement of the joint.

Arthrodesis is usually performed with joint resection or at least with removal of cartilage. Our recent experience with successful fusion in all 11 rheumatoid ankles treated only with percutaneous fixation questions the necessity of debridement of the joint before arthrodesis. In this rabbit study we tested the hypothesis that joints fuse because of rigid fixation. 9 skeletally mature loop-ear dwarf female rabbits were operated on. With the knee in about 45 degrees of flexion, two 1.5 mm cortical screws were inserted through the patellofemoral joint in an anterior-posterior direction with the lag screw technique. 3 rabbits were excluded due to technical problems. Of the remaining 6 rabbits, 5 underwent bony fusion and 1 fibrous healing. Fusion was confirmed with Micro-CT in 2 cases and by histological examination in all 5 cases. In those 5 cases, bony fusion was seen in almost all areas with close contact. Therefore, fusion occurred not only in relation to the screws, but also between the screws and in the periphery of the patella. Our findings show that bony fusion can occur in a healthy joint without joint resection or debridement.

Animals↗
PubMed1999

Triple arthrodesis and subtalar joint arthrodesis. For the treatment of end-stage posterior tibial tendon dysfunction.

The current literature clearly supports the use of subtalar and triple arthrodeses for the treatment of end-stage PTTD. There is debate, however, regarding whether or not an isolated fusion is preferable to the triple arthrodesis. Complete evaluation of the patient's deformity and symptoms is imperative before choosing to perform a rearfoot fusion. If the deformity can be isolated to the STJ, then perhaps a limited fusion is appropriate. With the close interrelationship of the subtalar and midtarsal joints, however, it is the authors' opinion that chronic dysfunction of the posterior tibial tendon infrequently causes isolated STJ pathology. Perhaps earlier intervention in the process of tendon degeneration, before multiple joint adaptations, would warrant an isolated fusion. We anticipate further research into the advantages of STJ and double arthrodeses over the triple arthrodesis. Clearer identification of the patients in whom these limited fusions are warranted is necessary, especially with respect to adult flatfoot secondary to PTTD. Currently, isolated and combined hindfoot fusions continue to be valuable salvage procedures in the treatment of end-stage arthritic deformities.

Adolescent↗
PubMed1992

Long-term evaluation of adolescents treated operatively for spondylolisthesis. A comparison of in situ arthrodesis only with in situ arthrodesis and reduction followed by immobilization in a cast.

The medical records and radiographs of forty-two adolescents (twenty-three male and nineteen female) who had had a posterolateral spinal arthrodesis for spondylolisthesis between 1950 and 1986 were reviewed to assess the long-term outcome of this form of treatment. The average age of the patients at the time of the operation was fourteen years (range, seven years and nine months to seventeen years and eleven months). The duration of the clinical and radiographic follow-up ranged from two years to twenty-seven years and seven months. All patients had an in situ arthrodesis of the involved vertebrae. Eighteen patients had no additional intervention, and twenty-four patients had reduction and application of a cast. Use of the cast led to a decrease in sagittal translation of more than 5 per cent in eighteen patients and a decrease in lumbosacral kyphosis (the slip angle) of more than 5 degrees in fourteen patients. Of the patients who did not have a cast, eight had an increase in sagittal translation of more than 5 per cent and ten had an increase in lumbosacral kyphosis of more than 5 degrees. There were no neurological problems at the time of the initial operation or after the reduction maneuver. At the most recent clinical follow-up examination, thirty-eight patients had no complaints of low-back pain or any restriction of work-related or recreational activities. Persistent low-back pain and pain in the lower extremities limited the activities of the remaining four patients, two of whom had another operation to alleviate these symptoms.

Adolescent↗
PubMed1990

Pseudarthrosis of the cervical spine after anterior arthrodesis. Treatment by posterior nerve-root decompression, stabilization, and arthrodesis.

Nineteen consecutive patients who had a symptomatic pseudarthrosis after a failed anterior cervical arthrodesis were treated by a posterior nerve-root decompression and arthrodesis. The indications for the operation were radiculopathy in the absence of myelopathy and evidence of a pseudarthrosis on lateral flexion and extension radiographs. The average duration of follow-up was forty-four months (range, twenty-four to fifty-four months). A solid fusion was achieved in all patients, and the radiculopathy was relieved in all but one. The motor weakness that had been present in four patients preoperatively resolved completely.

Adult↗
PubMed2001

Tibiotalocalcaneal arthrodesis: a biomechanical analysis of the rotational stability of the Biomet Ankle Arthrodesis Nail.

We hypothesized that the posterior-to-anterior (PA) calcaneal interlocking screw of the Biomet Ankle Arthrodesis Nail would increase rotational stability secondary to increased bone purchase compared with the standard lateral-to-medial (transverse) screw. Each of 10 fresh human cadaver lower limbs (five matched pairs) were stabilized with a nail inserted retrograde through the calcaneus, talus, and tibia according to standard technique. One limb of each pair was fixed with a transverse calcaneal screw; the contralateral limb, with a PA calcaneal screw. Each limb was then subjected to torsional testing on an MTS Mini Bionix load frame. The PA screw construct was significantly stiffer than the transverse screw construct: 1.96 and 1.41 Nm/E, respectively (P < 0.036).

Ankle Joint↗
PubMed1989

[Arthrodesis of the metacarpophalangeal joint of the thumb. Indications, technic, arthrodesis angle and functional effect].

The metacarpophalangeal joint of the thumb has less range of motion than any other digital joint. Its stability is more important than its mobility. Thus, arthrodesis of this joint causes relatively little loss of function, provided only that the joint is fused in the correct position. The authors reviewed all MP joint fusions of the thumb which were done at their hospital between 1974 and 1985. They examined individually forty-one of the fifty patients and studied the indications, surgical techniques and difficulties, and the complications. Furthermore, they measured all angles of fusion and concluded that the optimal position is fifteen degrees of flexion and ten degrees of pronation. The use of tension band wiring facilitates the achievement and maintenance of the desired position. The stability of the fusion permits exercise immediately after the operation; this helps to avoid a tenodesis of the long extensor tendon of the thumb.

Adolescent↗