Clinical outcomes of lateral malleolus osteotomy combined with cannulated screws and inverted proximal humeral locking plate fixation for the treatment of end-stage ankle osteoarthritis
10.3969/j.issn.1005-6483.20240990
- VernacularTitle:经外踝截骨联合空心钉和肱骨近端锁定钢板倒置固定治疗终末期踝关节骨关节炎的疗效观察
- Author:
Dexiang ZHANG
1
;
Yao ZHANG
1
;
Ming XIONG
1
;
Shaobing ZHANG
1
;
Chang CHEN
1
;
Song LIU
1
Author Information
1. 641300 四川大学华西医院资阳医院.资阳市中心医院骨科
- Publication Type:Journal Article
- Keywords:
end-stage ankle osteoarthritis;
lateral malleolus osteotomy;
ankle fusion;
proximal humeral locking plate;
cannulated screw
- From:
Journal of Clinical Surgery
2025;33(5):531-534
- CountryChina
- Language:Chinese
-
Abstract:
Objectives To retrospectively analyze the clinical outcomes of lateral malleolus osteotomy combined with cannulated screws and inverted proximal humerus locking plate fixation in the treatment of end-stage ankle osteoarthritis.Methods A clinical study was conducted on 21 patients with end-stage ankle osteoarthritis who were treated at our hospital from June 2018 to May 2022.Preoperative evaluations included weight-bearing X-rays to assess lower limb alignment and joint space,CT to evaluate the degree of bone sclerosis,and MRI to examine the extent of articular cartilage damage.The surgery involved a lateral malleolus osteotomy approach,using the resected lateral malleolus cartilage for grafting at the fusion site,and fixation of the tibiotalar joint with cannulated screws and an inverted proximal humerus locking plate.After the operation,the joint fusion was evaluated by X-ray films followed up in the outpatient department.The clinical efficacy was evaluated by using the Visual Analogue Scale(VAS)for pain and the Ankle and hindfoot Function Score of the American Orthopaedic Foot and Ankle Society(AOFAS).Results Twenty patients were followed up(95.2％follow-up rate)over a period of 14 to 40 months,with an average follow-up duration of 27.8 months.All 21 patients experienced primary wound healing.One patient developed lateral foot numbness,and 19 patients achieved primary osseous fusion.One patient with diabetes required secondary bone grafting with PRP injection to achieve fusion.Postoperative AOFAS scores significantly improved from a preoperative average of 45.7±3.3 to 84.7±3.3,while VAS scores for pain decreased from 7.54±1.83 preoperatively to 1.94±0.33 postoperatively(P＜0.05).Conclusion Lateral malleolus osteotomy combined with cannulated screws and inverted proximal humerus locking plate fixation for the treatment of end-stage ankle osteoarthritis demonstrated a high rate of fusion and low complication rates,The short-term outcomes are favorable,and the procedure eliminates the need for iliac bone grafting,indicating its potential for broader clinical application.
