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Arthrodeses of the Foot & Ankle

ARTHRODESIS

Indications:

  • posttraumatic arthritis

  • infection

  • paralytic conditions

  • salvage of failed total ankle arthroplasty.

Position: 

  • neutral dorsiflexion to 10deg. equinus

  • 5deg. valgus

  • 7deg. external rotation (equal to opposite side)

Techniques:

Approaches:

Approach   

Eponyms   

Description

Anterior longitudinal

Blair, Morris, Hand, Dunn   

 anterior longitudinal incision beginning 8 cm proximal to the ankle and ending at the medial cuneiform. Dissect the interval between the extensor hallucis longus and extensor digitorum longus, and retract the neurovascular bundle medially. Incise the capsule and periosteum in line with the skin incision.

Anterior Transverse Charnley see below
Oblique Ollier,  transverse incision extending from the talonavicular joint anteriorly to 1 cm below the lateral malleolus 
Transmalleolar - Lateral Horwitz; Adams 10 cm longitudinal incision over the subcutaneous surface of the distal fibula, ending 1.3 cm distal to the lateral malleolus. After subperiosteally exposing the fibula, osteotomize it 7.5 to 10 cm from its distal end
Transmalleolar - Medial Stewart & Harley Anteromedial incision; Use an osteotome to remove a longitudinal wedge of bone about 10 cm long and 1 to 1.5 cm wide from the medial tibia including the inner third of the medial malleolus; also include the medial side of the body of the talus.
Posterior Campbell allows for TA lengthening also.
Arthroscopic    


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Accessory Bones
Adult Hallux Valgus
Amputations of the Foot & Ankle
Anatomy of the Foot & Ankle
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Arthroscopy of the Foot & Ankle
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