Minimally Invasive Ankle Arthrodesis

  • Jamal Ahmad
  • Steven M. RaikinEmail author


The ankle joint is a constrained mortise and tenon-type joint consisting of the distal tibial plafond and fibula articulating with the dome of the talus. Arthritis of the ankle can result in pain, joint incongruence, decreased motion, and functional disability. The most common etiology of ankle arthritis is posttraumatic, which includes cartilaginous injury and ligamentous insufficiency.1 Other less common causes of arthritis include the inflammatory arthritides, osteonecrosis, infection, and Charcot neuroarthropathy.2

To date, the ankle remains one of the few major extremity joints in which arthrodesis is the gold standard surgical treatment for advanced arthritis that has failed nonoperative management. Open ankle arthrodesis was first described by Albert in 1879.3 Fusion through an open arthrotomy has received numerous modifications since that time, but remains a widely used technique for surgical exposure. Currently, the most common surgical exposure for open ankle arthrodesis is the lateral transfibular approach. Upon osteotomy, the distal fibula can be used either as bone graft or as a lateral strut to increase the stability of the arthrodesis construct. Preparations of the distal tibia and talar dome through these open techniques include either “dome” cuts or flat cuts. Dome cuts allow for minimal loss of height, but do not offer much in terms of angular correction. Straight, flat cuts allow for correction of significant deformity, but can result in loss of joint height.


Distal Tibia Total Ankle Arthroplasty Peroneal Artery Ankle Arthrodesis Distal Fibula 
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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Departments of Orthopaedic SurgeryRothman Institute and Thomas Jefferson University HospitalPhiladelphiaUSA

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