Ankle Arthritis: Ankle Fusion Minimally Invasive Approach With a Mini Plate

Ankle Arthritis: Ankle Fusion Minimally Invasive Approach With a Mini Plate

Here is a surgical demonstration on a left cadaver foot and ankle of an ankle joint fusion using a minimally invasive approach with a small plate and screws. The skin incision is made over the front of the ankle, right over the top of the joint. The surgeon will move all of the soft tissue and tendons out of the way to get down to the joint. All of the cartilage needs to get removed from the tibia and the talus. If there is any cartilage left between these two bones, they may not heal together.

First, a small incision is made on the inside of the ankle and the surgeon will place two pins all the way down through both bones. Next, a screw is placed over each pin to hold the two bones together so they do not move. To provide more stability, the surgeon will put a small plate on the front of the ankle. It is important that the ankle joint does not move at all during the recovery process so the bones heal together nice and strong.

The plate is put in the proper position and the plate is held in place with a ball-headed pin. A small hole is drilled in the talus so that the first screw can be inserted. The pin is removed and a small hole is drilled at the top of this oval-shaped hole in the plate. Once the screw is inserted, this will shift the plate up, compressing the tibia and talus bones together. Compression of the 2 bones helps with healing.

There is 1 more hole in the top of the plate. A small hole is drilled into the bone and the final screw is placed. The surgeon is using a ruler to show how small the incision is. Only an inch and a half long or about 4 cm. In this x-ray view from the front, here are the first 2 screws that were placed through the joint. This x-ray from the side shows the small plate and final 3 screws holding everything together. The incision gets closed with stitches and the patient will start the recovery process.