Evaluation of the results of intraarticular ankle arthrodesis by two methods

Arthrodesis of the upper ankle joint remains the method of choice in the treatment of arthrodesis of this ankle. A retrospective, comparative study was carried out of 70 patients who had undergone arthrodesis of the upper ankle joint between 1972 and 1988. The first group included 37 patients operated on using arthrodesis following Adams-Horwitz (A-H), and second group comprised 33 patients in whom an arthrodesis had been performed with external fixation according to the principles of the Arbeitsgemeinschaft fr Osteosynthesefragen (A-O). Radiographs of the foot in the sagittal plane taken prior to, immediately upon and four years after the operative procedure were analyzed. The arthrodesis angle was measured according to the Morrey and Wiedeman system. The comparison angle measured on the radiographs in a healthy foot was 100 degrees (clinically neutral foot position). An increase in the arthrodesis angle results in the equinus position of the foot, and an ankle angle of 120 degrees or greater was considered a complication. The analysis showed that the equinus position of the foot (the angle of 120 degrees or greater) appeared as a complication in patients who underwent upper ankle joint arthrodesis using the Adams-Horwitz method. This correlation supports arthrodesis using external fixation according to the A-O principles, that is solid compression arthrodesis, which gives a neutral foot position.