Pradana Ananto Satya, Phatama Krisna Yuarno, Mustamsir Edi, Cahyono Ganang Dwi, Oktafandi I Gusti Ngurah Arga Aldrian, Hidayat Mohamad
Orthopaedic and Traumatology Department, Faculty of Medicine, Brawijaya University-Saiful Anwar General Hospital, Malang, East Java, Indonesia.
Ann Med Surg (Lond). 2021 Mar 26;65:102250. doi: 10.1016/j.amsu.2021.102250. eCollection 2021 May.
Ankle arthrodesis is one of the managements for a significantly unstable Charcot ankle. Some of the methods of internal fixation for ankle arthrodesis include the use of intramedullary nails, screws, and plates. Ankle arthrodesis using intramedullary nails has become more popular. However, studies evaluating the use of plate fixation, particularly double posterior lateral plating, are limited. We report the clinical and radiological outcomes of double posterior lateral plating ankle arthrodesis in three diabetic Charcot ankle patients.
Three patients, aged 73, 67, and 65 years old, complained of ankle pain and with a history of type 2 diabetes mellitus. The physical examination revealed swelling and erythema without a sign of active infection. The radiological examination showed ankle deformity, and the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot scores were 5, 10, and 0, respectively. All patients were diagnosed with a diabetic Charcot ankle and underwent ankle arthrodesis using double posterior lateral plating. Four months and six months follow up revealed talus union, improved ankle deformity, and improved AOFAS Ankle-Hindfoot scores to 70, 76, and 73, respectively.
Various methods of ankle arthrodesis are retrograde intramedullary nails, screws, and plates. In this report, we opt for plate fixation because it allows for stable internal fixation, adequate compression, high angular stability, and a lower irreversible deformation in osteoporotic bone.
Double posterior lateral plating ankle arthrodesis provided satisfactory clinical and radiological outcomes. This method can be an alternative for patients with Charcot ankle requiring ankle arthrodesis.
踝关节融合术是治疗严重不稳定型夏科氏踝关节的方法之一。踝关节融合术的一些内固定方法包括使用髓内钉、螺钉和钢板。使用髓内钉进行踝关节融合术越来越受欢迎。然而，评估钢板固定，特别是双后外侧钢板固定的研究有限。我们报告了三例糖尿病性夏科氏踝关节患者采用双后外侧钢板固定踝关节融合术的临床和放射学结果。
三名患者，年龄分别为73岁、67岁和65岁，主诉踝关节疼痛，有2型糖尿病病史。体格检查发现肿胀和红斑，无活动性感染迹象。放射学检查显示踝关节畸形，美国矫形足踝协会（AOFAS）踝-后足评分分别为5分、10分和0分。所有患者均被诊断为糖尿病性夏科氏踝关节，并接受了双后外侧钢板固定的踝关节融合术。随访4个月和6个月时，距骨愈合，踝关节畸形改善，AOFAS踝-后足评分分别提高到70分、76分和73分。
踝关节融合术的各种方法包括逆行髓内钉、螺钉和钢板。在本报告中，我们选择钢板固定，因为它能提供稳定的内固定、足够的加压、高角度稳定性，并且在骨质疏松性骨中产生较低的不可逆变形。
双后外侧钢板固定踝关节融合术提供了满意的临床和放射学结果。这种方法可以作为需要进行踝关节融合术的夏科氏踝关节患者的一种选择。
