Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Comparison of the Outcomes between the Anterior and Transfibular Approaches in Ankle Arthrodesis

전방 도달법과 경비골 도달법을 이용한 족관절 유합술의 결과 비교

  • Jaeyoung Lee (Department of Orthopedic Surgery, Bucheon St. Mary's Maryrthoped, College of Medicine, The Catholic Universtiy of Korea) ;
  • Min-Jun Kim (Department of Orthopedic Surgery, Bucheon St. Mary's Maryrthoped, College of Medicine, The Catholic Universtiy of Korea) ;
  • Jin-Wha Chung (Department of Orthopedic Surgery, Bucheon St. Mary's Maryrthoped, College of Medicine, The Catholic Universtiy of Korea)
  • 이재영 (가톨릭대학교 의과대학 부천성모병원 정형외과학교실) ;
  • 김민준 (가톨릭대학교 의과대학 부천성모병원 정형외과학교실) ;
  • 정진화 (가톨릭대학교 의과대학 부천성모병원 정형외과학교실)
  • Received : 2023.10.13
  • Accepted : 2023.11.07
  • Published : 2023.12.15
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Abstract

Purpose: This study compared the clinical and radiology results of arthrodesis between the anterior and transfibular approaches with a lateral malleolar-saving procedure in ankle arthritis. Materials and Methods: This study was a retrospective study of 31 cases who underwent ankle arthrodesis with the anterior approach (14 cases) and trans-fibular approach (17 cases). The remnant lateral malleolus was fixed during the trans-fibular procedure. The patients included 17 females and 14 males with a mean age of 57.2 (range 41~73) years; the mean follow-up was 30.4 (range 15~68) months. The clinical and radiology outcomes, including the American Orthopedic Foot & Ankle Society (AOFAS) scores, visual analog scale (VAS), and union time, were recorded. The complications and subjective satisfaction degrees were also recorded and compared between the two groups. Results: Clinically, the preoperative mean AOFAS score and VAS in the anterior approach group were 39.3 and 7.4, respectively, which changed to 61.9 and 3.1 postoperatively. In the trans-fibular approach group, the mean AOFAS score and VAS increased from 36.6 to 64.2 and 7.1 to 2.4, respectively. On the other hand, no significant differences in the clinical results were observed between the two groups. The time to achieve union was 9.2 and 11.6 weeks in the anterior and transfibular approach groups, respectively. Three patients (21%) complained of tenderness and discomfort around the fibular tip in the anterior approach group, and seven patients (41%) showed a gap between the talus and remnant lateral malleolus in the trans-fibular approach group. Conclusion: There was no difference in the clinical and radiological results between the anterior and transfibular approaches with a lateral malleolar saving procedure in ankle arthrodesis. Careful selection of the approach method according to the patient's preoperative condition is needed to prevent remnant discomfort or nonunion around the lateral malleolus.

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References

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