Ankle arthrodesis. A comparison of an arthroscopic and an open method of treatment.

An arthroscopic technique and an open technique with malleolar ostectomy for ankle arthrodesis is described and compared. Internal fixation with compression across the tibiotalar joint was utilized for both methods using either 6.5-mm or 7.0-mm cannulated screws. The indications, advantages, results, and complications of these two fusion techniques in 33 patients are reported. Arthroscopic arthrodesis was performed in 17 patients, using open arthrotomy and malleolar ostectomy in 16. The mean time to arthrodesis for patients having the procedure arthroscopically was 8.7 weeks (range, six to 14 weeks), compared to 14.5 weeks in the open arthrotomy group (range, eight to 26 weeks; p less than 0.004). Despite differences in patient selection for each of the two groups, it was concluded that disabling ankle arthritis for certain patients may be more appropriately managed with arthroscopic arthrodesis than by arthrotomy and malleolar ostectomy, utilizing similar methods of internal fixation.