Comparison of anterior plate and cross screw versus posterior plate in ankle arthrodesis
10.3760/cma.j.cn115530-20231229-00280
- VernacularTitle:前侧入路接骨板联合交叉螺钉与后侧入路接骨板行踝关节融合术的疗效比较
- Author:
Yang YUE
1
;
Xiaojun LIANG
;
Hui FENG
;
Hongmou ZHAO
;
Jingqi LIANG
Author Information
1. 西安交通大学附属红会医院足踝外科，西安 710054
- Keywords:
Ankle;
Osteoarthritis;
Arthrodesis;
Internal fixators
- From:
Chinese Journal of Orthopaedic Trauma
2024;26(7):557-562
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the clinical efficacy between fusion with anterior plate and cross screw (APCS) via the anterolateral approach and that with posterior plate (PP) via the posterior approach in ankle arthrodesis.Methods:A retrospective study was conducted to analyze the 64 patients (64 feet) with end-stage ankle arthritis who had been admitted to Department of Foot and Ankle Surgery, Honghui Hospital of Xi'an Jiaotong University from January 2017 to March 2021. They were 24 males and 40 females with an age of (57.7±5.5) years; by the Kellgren-Lawrence staging, 25 cases were in grade Ⅲ and 39 ones in grade Ⅳ. According to the different surgical approaches and internal fixation methods, the patients were divided into a APCS group of 31 cases subjected to the fusion with APCS via the anterolateral approach and a PP group of 33 cases subjected to the fusion with PP via the posterior approach. The clinical efficacy was compared between the 2 groups and between preoperatoion and postoperation in terms of talus center migration (TCM), sagittal talar migration (STM), foot and ankle ability measure (FAAM), and visual analog scale (VAS).Results:There was no statistically significant difference in the preoperative baseline data between the 2 groups of patients, indicating comparability ( P>0.05). In the PP group, the postoperative STM [(4.45±2.21)] mm was significantly smaller than the postoperative one [(7.22±4.22)] mm ( P<0.001). There were no statistically significant differences in the postoperative comparisons of TCM and STM between the 2 groups, in the comparison between postoperative TCM and preoperative TCM in the PP group, or in the comparisons between postoperative and preoperative TCM and STM in the APCS group ( P>0.05). All patients were followed up for (28.1±6.8) months. At the last follow-up, there was no statistically significant difference between the 2 groups in the FAAM life score, FAAM exercise score, or VAS pain score ( P>0.05). The FAAM life score, FAAM motor score, and VAS pain score at the last follow-up were significantly improved in all the patients compared with the preoperative values ( P<0.05). Fusion failure was found in only 1 patient in the APCS group. Conclusion:Both PP and APCS fusion techniques can lead to similarly fine clinical outcomes in ankle arthrodesis, but PP may lead to a significant correction of sagittal talar migration.
