[Fixation or screws in arthrodeses of the upper ankle joint. A retrospective comparison of 76 patients].

In a retrospective study, the results of 76 patients treated by different methods for arthrodesis of the ankle joint were compared. With external-compression clamps, solid fusion was achieved in 48 patients after an average of 4.5 months, with lag-screw fixation in 25 patients after 3 months. The nonunion rate was only 4% in the group with external clamps, the followup time was 2 years (maximum 6 years, minimum 6 months). Eighty percent of the patients reported pain relief, 58% in the lag-screw reported being free of symptoms, 23% as did of the external-clamps group. Most of the complications after external fixation were related to pin-site infections (48%). Infection, instability and inability to undergo physiotherapy were the main problems after clamps. Arthrodesis with lag screws provides optimal biomechanical fixation, with early functional treatment and a fusion within 3 months. Compared to external clamps arthrodesis, the lag-screw group had fewer problems with skin and bone healing and could be discharged earlier.