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Australian Veterinary Journal Apr 2019Five dogs (4 with severe carpal contracture, 1 with a chronically infected carpal joint) underwent antebrachiometacarpal arthrodesis. Excision of all carpal bones,...
CASE REPORTS
Five dogs (4 with severe carpal contracture, 1 with a chronically infected carpal joint) underwent antebrachiometacarpal arthrodesis. Excision of all carpal bones, except the accessory carpal bone, was done, either because of persistent infection or to allow the manus to be arthrodesed in a functional position. All five dogs developed varying degrees of soft tissue swelling of the surgical site following surgery. All five arthrodeses achieved complete osseous union within 4-67 weeks. The immediate postoperative distal radiometacarpal frontal plane angulation ranged from 1° to 19° (mean ± SD: 7 ± 8°). The immediate postoperative distal radiometacarpal sagittal plane angulation ranged from 6° to 26° (mean ± SD: 17 ± 9°). Plate coverage of the secured metacarpal bone(s) ranged from 75% to 87% (mean ± SD: 80 ± 4%). Infection necessitated plate removal in four dogs, 3-17 (mean ± SD: 8 ± 6) months following surgery and 0-15 (mean ± SD: 5 ± 7) weeks following radiographic documentation of complete osseous union.
CONCLUSION
Despite one dog having marked elbow incongruency and degenerative joint disease and one dog having an ipsilateral radial nerve deficit, all five dogs improved and had acceptable limb function at the time of the final evaluation, which ranged from 25 to 296 (mean ± SD: 99 ± 111) weeks following surgery.
Topics: Animals; Arthrodesis; Bone Plates; Carpal Bones; Carpus, Animal; Dogs; Female; Male; Treatment Outcome
PubMed: 30919437
DOI: 10.1111/avj.12795 -
Der Unfallchirurg Sep 2013If adequate conservative measures for the treatment of end-stage ankle osteoarthritis have failed, surgery may be taken into consideration. After exorbitant failure... (Review)
Review
If adequate conservative measures for the treatment of end-stage ankle osteoarthritis have failed, surgery may be taken into consideration. After exorbitant failure rates in the beginning of total ankle replacement, nowadays this kind of treatment has regained lot of interest and has become a viable alternative to ankle fusion. The correct indication and a precise explanation of the surgical procedure, outcomes and potential complications provide a solid base for future success.Currently, there is no doubt that total ankle replacement has become an important player in the treatment of symptomatic and debilitating end-stage ankle arthritis. With increasing number of patients who undergo total ankle replacement the experience with this kind of procedure increases too. As a consequence several surgeons have started to stretch indications favoring total ankle replacement. However, it must be mentioned here, despite progress in terms of improved anatomical and biomechanical understanding of the hindfoot and improved surgical techniques and instruments, total ankle replacement and ankle fusion remain challenging and difficult procedures. We provide a review article including an overview of the relevant techniques. This article should serve as rough guide for surgeons and help in decision-making regarding total ankle replacement and ankle fusion.
Topics: Ankle Joint; Arthrodesis; Arthroplasty, Replacement, Ankle; Humans; Osteoarthritis
PubMed: 23979169
DOI: 10.1007/s00113-013-2386-1 -
The Journal of Bone and Joint Surgery.... Jun 2008Contemporary recommendations for primary and revision ankle arthrodesis favor internal compression techniques involving the use of screw and/or plate fixation. While...
BACKGROUND
Contemporary recommendations for primary and revision ankle arthrodesis favor internal compression techniques involving the use of screw and/or plate fixation. While tibiotalocalcaneal arthrodesis with internal fixation may be a suitable method of salvage for the treatment of a failed tibiotalar arthrodesis in selected patients, ring external fixation has been reported as an alternative. We reviewed our experience with revision tibiotalar arthrodesis, with a focus on ring external fixation.
METHODS
Forty-five consecutive patients underwent revision tibiotalar arthrodesis with use of repeat internal fixation (eleven patients), ring external fixation (twenty-two patients), or tibiotalocalcaneal arthrodesis (twelve patients). Union rates were assessed radiographically, and functional outcome was determined with use of preoperative and postoperative American Orthopaedic Foot and Ankle Society ankle-hindfoot scores.
RESULTS
All forty-five patients were available for follow-up at an average of 50.3 months. The average ankle-hindfoot score improved from 31.1 points preoperatively to 65.8 points at the time of the most recent follow-up. At the time of the most recent follow-up, the union rate was 88.9% (forty of forty-five). Fusion was achieved with revision tibiotalar arthrodesis in thirty-six (80%) of forty-five patients, including eight of the eleven patients in the repeat internal fixation group, nineteen of the twenty-two patients in the ring external fixation group, and nine of the twelve patients in the tibiotalocalcaneal arthrodesis group. Re-revision led to union in four of five patients. The overall union rate for ring external fixation, including revision and re-revision tibiotalar arthrodeses, was 84.6% (twenty-two of twenty-six). The five patients with persistent nonunion following revision ankle arthrodesis opted for transtibial amputation.
CONCLUSIONS
Revision tibiotalar arthrodesis leads to satisfactory limb salvage in a majority of patients. Ring external fixation may facilitate clinically acceptable limb salvage in complex cases when methods of internal fixation are limited or even contraindicated.
Topics: Aftercare; Ankle Joint; Arthrodesis; Female; Humans; Limb Salvage; Logistic Models; Male; Orthopedic Fixation Devices; Postoperative Complications; Radiography; Reoperation; Subtalar Joint; Tibia; Treatment Outcome
PubMed: 18519313
DOI: 10.2106/JBJS.G.00506 -
Seminars in Surgical Oncology 1997Advances in chemotherapy and radiographic imaging have allowed resection and limb-salvage surgery to be performed on the majority of patients with bone tumors. Extensive... (Review)
Review
Advances in chemotherapy and radiographic imaging have allowed resection and limb-salvage surgery to be performed on the majority of patients with bone tumors. Extensive soft tissue resection, extra-articular resection, and social factors often contraindicate a mobile reconstruction of the involved or adjacent joint. In these cases, an arthrodesis often can maintain a functional extremity. Current soft tissue techniques and advances in orthopedic hardware have minimized complications and allowed successful outcomes for the majority of patients. This article reviews resection arthrodeses about the knee, shoulder, wrist, and ankle. The surgical technique, complications, and functional outcomes of these procedures are presented.
Topics: Ankle; Arthrodesis; Bone Neoplasms; Humans; Knee; Shoulder; Wrist
PubMed: 9025179
DOI: 10.1002/(sici)1098-2388(199701/02)13:1<25::aid-ssu5>3.0.co;2-6 -
Clinical Orthopaedics and Related... Oct 2001Midfoot and hindfoot arthrodeses traditionally have been done to treat deformities resulting from paralytic disorders, residual clubfoot deformity, and posttraumatic... (Review)
Review
Midfoot and hindfoot arthrodeses traditionally have been done to treat deformities resulting from paralytic disorders, residual clubfoot deformity, and posttraumatic arthritis. The surgical indications for midfoot and hindfoot arthrodeses more recently have been expanded to include painful arthritic deformities associated with neuroarthropathy, seropositive or seronegative arthropathies, and neurologic disorders. Regardless of the joint fused or the technique used, the goal of each remains similar: the creation of a painless, plantigrade foot capable of being fitted into, at the very least, a custom shoe. The aim of the current study is to describe the major complications associated with midfoot and hindfoot fusions in adults, and the prevention and the treatment of these complications.
Topics: Arthrodesis; Foot Bones; Humans; Infections; Peripheral Nervous System Diseases; Postoperative Complications; Reoperation; Time Factors
PubMed: 11603689
DOI: 10.1097/00003086-200110000-00007 -
Hand Surgery & Rehabilitation Dec 2022Conventional open arthrodesis for the thumb metacarpophalangeal joint provides excellent results but can incur complications. The aim of this study was to evaluate the...
Conventional open arthrodesis for the thumb metacarpophalangeal joint provides excellent results but can incur complications. The aim of this study was to evaluate the feasibility and safety of resecting the thumb metacarpophalangeal articular surfaces via an arthroscopic approach or a percutaneous approach under fluoroscopic control. This cadaver study was carried out on 14 thumbs. Ten were operated on arthroscopically, and four percutaneously under fluoroscopic control. The efficacy and safety of the respective procedures were evaluated after dissecting soft tissue and opening the joint. Following 2 insufficient resections using the arthroscopic technique, the procedure was modified, providing satisfactory resection in 80% of cases overall and no tendinous or neurovascular lesions. Percutaneous resection under fluoroscopy did not yield satisfactory results, especially on the volar part of the metacarpal articular surface. We believe these results would justify comparative clinical studies to evaluate fusion of the thumb metacarpophalangeal joint with arthroscopic joint surface resection followed by percutaneous fixation. LEVEL OF EVIDENCE: IV.
Topics: Humans; Thumb; Feasibility Studies; Arthrodesis; Metacarpophalangeal Joint; Metacarpal Bones
PubMed: 36038110
DOI: 10.1016/j.hansur.2022.08.008 -
Der Orthopade Apr 1996The AO technique of wrist arthrodesis with an embedded iliac crest bone graft is a stable kind of fixation that allows early range of motion. Solid fusion with... (Review)
Review
The AO technique of wrist arthrodesis with an embedded iliac crest bone graft is a stable kind of fixation that allows early range of motion. Solid fusion with correction of the deformity and relief of pain can be achieved. A correct position in dorsal extension and ulnar abduction will improve hand function, but a decrease in grip strength must be expected.
Topics: Adult; Arthrodesis; Bone Plates; Bone Transplantation; Female; Hand Strength; Humans; Male; Middle Aged; Osteoarthritis; Radiography; Range of Motion, Articular; Wrist Joint
PubMed: 8692564
DOI: No ID Found -
Subtalar Arthrodesis in Patients With Prior Tibiotalar Arthrodesis for Posttraumatic Osteoarthritis.Foot & Ankle International Sep 2023The tibiotalar arthrodesis for end-stage ankle osteoarthritis is a surgical procedure that leads to a modification of the kinematics of the adjacent joints and may...
BACKGROUND
The tibiotalar arthrodesis for end-stage ankle osteoarthritis is a surgical procedure that leads to a modification of the kinematics of the adjacent joints and may result in the development of secondary osteoarthritic degeneration of the subtalar joint. It has previously been observed that subtalar arthrodesis in this context shows a lower fusion rate than isolated subtalar arthrodesis. This retrospective study reports the results of subtalar joint arthrodesis with previous ipsilateral tibiotalar arthrodesis and suggests some factors that may compromise the fusion of the joint.
METHODS
Between September 2010 and October 2021, 15 arthrodeses of the subtalar joint with screw fixation were performed in 14 patients, with a fusion of the ipsilateral tibiotalar joint. Fourteen of 15 cases used an open sinus tarsi approach, 13 were augmented with iliac crest bone graft, and 11 had supplemental demineralized bone matrix (DBM). The outcome variables were fusion rate, time to fusion, and revision rate. Fusion was assessed by radiographs and computed tomography scan.
RESULTS
Twelve of the 15 subtalar arthrodeses (80%) fused at the first attempt with an average fusion time of 4.7 months.
CONCLUSION
In this limited retrospective case series, compared to the fusion rate of isolated subtalar arthrodesis reported in the literature, the rate of subtalar fusion in the presence of an ipsilateral tibiotalar arthrodesis was found to be lower.
LEVEL OF EVIDENCE
Level IV, retrospective case series.
Topics: Humans; Retrospective Studies; Ankle Joint; Treatment Outcome; Osteoarthritis; Arthrodesis; Subtalar Joint
PubMed: 37434387
DOI: 10.1177/10711007231181568 -
European Journal of Orthopaedic Surgery... Dec 2022The primary objective of this study was to compare the radiological and clinical results of anterograde and retrograde screwing in subtalar arthrodesis using a single...
INTRODUCTION
The primary objective of this study was to compare the radiological and clinical results of anterograde and retrograde screwing in subtalar arthrodesis using a single compression screw. The secondary objective was to evaluate the subjective results and consolidation of this procedure. The hypotheses were that isolated screw fixation was sufficient to achieve good consolidation and that there was no difference between the two techniques with a similar rate of bone fusion.
METHODS
This is a monocentric, retrospective, radio-clinical study based on 99 patients (101 feet), 58 males and 41 females, with an average age of 64 years. The main aetiology was post-traumatic osteoarthritis, which represented 51% of cases. Two groups were formed: group A (52 feet) consisting of fixed arthrodesis with ascending (retrograde) screwing and group D (49 feet) consisting of fixed arthrodesis with descending (anterograde) screwing. The two groups were statistically comparable in terms of demographic data as well as aetiologies and comorbidities. Arthrodeses which were not fused at 6 months were reassessed at one year and in the event of any radio-clinical doubt regarding consolidation, an additional CT scan was prescribed. Average post-operative follow-up was 11 ± 5 years (2-27 years).
RESULTS
Ninety-two arthrodeses (93%) were fused at one year and 9 were considered to be in non-union, 5 (9.8%) in group A, and 4 (8.3%) in group D. We recorded 30 complications, 22 of which were due to a conflict with the screw head, 18 (34.5%) in group A and 4 (8.3%) in group D (p = 0.03). Conflict between the screw head and the heel led to the removal of the screw after consolidation of the arthrodesis. The clinical results were evaluated using Odom's criteria. Nine per cent of patients described their results as excellent, 29% as good, 51% as satisfactory and 11% found the result to be poor.
CONCLUSION
The fusion rate for isolated compression screw arthrodesis is good, and there is no difference between anterograde and retrograde screws. However, the discomfort caused by the screw head being insufficiently embedded in the retrograde group led to a non-negligible number of additional surgeries to remove the screw.
Topics: Male; Female; Humans; Middle Aged; Subtalar Joint; Retrospective Studies; Bone Screws; Arthrodesis; Osteoarthritis
PubMed: 34623469
DOI: 10.1007/s00590-021-03141-7 -
Der Orthopade Apr 2006Arthrodesis of the first metatarsophalangeal joint is a useful technique for the surgical treatment of hallux rigidus, complicated hallux valgus and rheumatoid forefoot... (Review)
Review
Arthrodesis of the first metatarsophalangeal joint is a useful technique for the surgical treatment of hallux rigidus, complicated hallux valgus and rheumatoid forefoot deformity, and for revisions following resection arthroplasty or explantation of a prosthesis combined with interposition of a tricortical bone graft. In primary operations, good or excellent results can be achieved in 80-90% of patients. The articular surface and any exostoses or osteophytes are first resected aiming for a 15-30 degrees extension of the metatarsophalangeal angle and a 5-15 degrees valgus angle. Pseudarthroses occur in 10-13% of arthrodeses stabilized with screws or k-wires. When using a plate for fixation, the rate of pseudarthroses is below 6%. Only a small number of pseudarthroses require revision surgery. Up to 15% of patients develop mostly asymptomatic degeneration of the interphalangeal joint of the hallux.
Topics: Arthrodesis; Foot Deformities; Humans; Internal Fixators; Joint Instability; Metatarsophalangeal Joint; Practice Guidelines as Topic; Practice Patterns, Physicians'; Plastic Surgery Procedures
PubMed: 16184391
DOI: 10.1007/s00132-005-0867-9