Effectiveness and safety of modified sliding chute bone graft
plus hollow screw fixation for tibiotalar joint fusion

doi:10.3969/j.issn.2095-4344.2426

Abstract

Abstract:

BACKGROUND: Tibiotalar joint fusion ways are various, and it is a difficulty in necrotic tibiotalar joint fusion. There are few comparative studies on the repair outcomes of each implant.

OBJECTIVE: To compare the effectiveness and safety of modified sliding chute bone graft plus hollow screw fixation with simple screw internal fixation and plate internal fixation for tibiotalar joint fusion.

METHODS: Fifty-six patients who underwent tibiotalar joint fusion were included, including 16 cases of screw fixation, 22 cases of plate fixation and 18 cases of modified sliding chute bone graft plus hollow screw fixation. Ankle function was compared after simple screw internal fixation, plate internal fixation and modified sliding chute bone graft plus hollow screw fixation. The ankle foot scoring system of American Orthopedic Foot and Ankle Society was used for evaluation. At the same time, the operation time, brace fixation time and fusion time of the three surgical methods were compared. The gait at the last follow-up was compared. The average follow-up time was 2.4 years. The experiment met the ethical requirements of the First Affiliated Hospital of Harbin Medical University. All patients provided written informed consent for study participation.

RESULTS AND CONCLUSION: (1) All the patients obtained exactly bony fusion. Compared with the plate fixation group, the slide bone grafting group had significant advantages in the fusion time and the last gait (P < 0.05), and the screw fixation group had significant advantages in the operation time (P < 0.05). (2) Using the ankle foot scoring system of American Orthopedic Foot and Ankle society, there was no significant difference between the sliding chute bone graft group and the plate fixation group, but both groups were significantly better than the screw fixation group (P < 0.05). (3) Adverse events had not been found in each group. (4) These results suggest that modified sliding chute bone graft plus hollow screw fixation for ankle joint fusion can effectively improve ankle joint fusion rate compared with single screw fixation, which is effective and safe.

Key words: sliding chute bone graft, modified, tibiotalar joint, fusion, hollow screw, plate, talus osteonecrosis, fixation outcomes, ankle function

CLC Number:

Han Xinguang, Yin Zhijiang, Wang Xiangcheng, Yang Chenyu, Shang Jian. Effectiveness and safety of modified sliding chute bone graft plus hollow screw fixation for tibiotalar joint fusion[J]. Chinese Journal of Tissue Engineering Research, 2020, 24(6): 839-842.

Figures/Tables 7

References

[1] 高大龙,李若飞,刘刚.踝关节融合术治疗大骨节病性距骨坏死[J].中国骨与关节损伤杂志,2012,27(6):561-562.
[2] PUGELY AJ, LU X, AMENDOLA A, et al. Trends in the use of total ankle replacement and ankle arthrodesis in the United States Medicare population. Foot Ankle Int. 2014;35:207-215.
[3] PINZUR MS, NOONAN T. Ankle arthrodesis with a retrograde femoral nail for Charcot ankle arthropathy. Foot Ankle Int. 2005;26(7):545-549.
[4] 严广斌.AOFAS踝-后足评分系统[J].中华关节外科杂志(电子版),2014, 8(4):557.
[5] DENNIS MD, TULLOS HS. Blair tibiotalar arthrodesis for injuries to the talus. J Bone Joint Surg Am. 1980;62(1):103-107.
[6] LIN SY, CHENG YM, HUANG PJ, et al. Modified Blair method for ankle arthrodesis. Kaohsiung J Med Sci. 1998;14(4):217-220.
[7] WANG S, HUANG Z, XIONG G, et al. Modified Blair ankle fusion for ankle arthritis. Chin J Traumatol. 2014;17(3):136-140.
[8] ANDERSON JG, COETZEE JC, HANSEN ST. Revision ankle fusion using internal compression arthrodesis with screw fixation. Foot Ankle Int. 1997;18(5):300-309.
[9] GHAREHDAGHI M, RAHIMI H, MOUSAVIAN A. Anterior ankle arthrodesis with molded plate: technique and outcomes. Arch Bone Jt Surg. 2014;2(3):203-209.
[10] SLATER GL, SAYRES SC, O'MALLEY MJ. Anterior ankle arthrodesis. World J Orthop. 2014;5(1):1-5.
[11] WIEWIORSKI M, BARG A, SCHLEMMER T, et al. Ankle joint fusion with an anatomically preshaped anterior locking plate. J Foot Ankle Surg. 2016;55(2):414-417.
[12] 代加楠,刘娜,杨志奎,等.腓骨支撑踝关节融合术治疗大骨节病性距骨坏死[J].实用骨科杂志,2015,21(3):275-277.
[13] 杨坤芳,俞光荣.踝关节融合术的治疗进展[J].中国矫形外科杂志,2008, 16(24):1871-1873.
[14] 武勇,王岩,王金辉,等.踝关节融合治疗创伤后踝关节炎[J].中华骨科杂志, 2013,33(4):409-413.

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