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Simultaneous tibio-talar fusion and tibial lengthening for end-stage ankle arthritis

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

Arthrodesis of the ankle joint is an accepted treatment option in patients with end-stage ankle arthritis. The goal is to achieve fusion between the tibia and the talus, thereby stabilizing the joint and alleviating pain. There might be associated limb length discrepancy, especially in post-traumatic and post-infectious cases. These patients require limb lengthening and arthrodesis. The purpose of this study is to report our experience with simultaneous ankle arthrodesis and lengthening using external fixation in adolescent and young adult patients.

Methods

This retrospective case series included all patients treated in our hospital by concomitant ankle arthrodesis and tibial lengthening procedures on the same limb, using ring external fixation system. All surgeries included distal tibial joint surface resection and the talar dome, thereby correcting any associated deformity at the ankle. The arthrodesis was fixed and compressed using ring external fixator. A concurrent proximal tibial osteotomy was done, and limb lengthening, or bone transport was performed.

Results

Eight patients operated between the years 2012–2020 were included in this study. Median patient age was 20.4 years (range 4–62 years), 50% women. Median limb lengthening was 20 mm (range 10–55 mm), and median final leg length discrepancy (LLD) was 7.5 mm (range 1–72 mm). The most common complication recorded was pin tract infection, which resolved with empiric antibiotics in all cases.

Conclusion

Based on our experience, combined arthrodesis and proximal tibial lengthening is efficient solution that provides stable ankle and restores length of the tibia even in complex and challenging situations.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Israel Defense Forces, Medical Corps, Ramat Gan, Israel

    Omri Besor

  2. Pediatric Orthopedics, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel

    Mark Eidelman & Pavel Kotlarsky

Authors
  1. Omri Besor
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  2. Mark Eidelman
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  3. Pavel Kotlarsky
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Contributions

The manuscript has been read and approved by all authors, and the requirements for authorship have been met, and each author believes that the manuscript represents honest work.Individual Authors contributions: OB contributed to data collection, statistical analysis and manuscript preparation. ME contributed to study design, data collection and manuscript preparation. PK contributed to study design and manuscript preparation.

Corresponding author

Correspondence to Omri Besor.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of the Rambam Health Care Campus approved this study.

Informed consent

As this is a retrospective chart review, and no identifiable information appears in the processed and published data, the requirement for consent was waived by the IRB of the Rambam Health Care Campus.

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Besor, O., Eidelman, M. & Kotlarsky, P. Simultaneous tibio-talar fusion and tibial lengthening for end-stage ankle arthritis. Eur J Orthop Surg Traumatol 33, 3501–3509 (2023). https://doi.org/10.1007/s00590-023-03579-x

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  • DOI: https://doi.org/10.1007/s00590-023-03579-x

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