Ankle Arthritis: Open Ankle Joint Fusion With a Plate and Screws
Ankle Arthritis: Open Ankle Joint Fusion With a Plate and Screws
This surgical video demonstrates an ankle joint fusion for the treatment of ankle arthritis.
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Ankle Arthritis: Open Ankle Joint Fusion With a Plate and Screws
This surgical demonstration on a patient's left ankle shows an open ankle joint fusion using a plate and screws for the treatment of ankle arthritis. First, an incision is made over the front of the ankle joint. The incision is typically about 5-6 in or 12-15 cm long.
Once all the ankle tendons and soft tissue are out of the way, the surgeon has to get into the ankle joint to remove all the cartilage. Since the goal is to get both the tibia and talus bones healed to each other, there cannot be any cartilage between the bones. Usually, there are bone spurs on the front that the surgeon has to take off before getting into the joint to remove the cartilage.
After the cartilage is removed, the surgeon positions the ankle and checks the fit of the plate that will be used. Once the plate is in place and flush against the bone, a screw is placed in the bone, holding the plate in place. The surgeon makes sure they like the position and will continue to place the remaining screws into the talus bone through the plate.
At this point, the plate needs to be fixed to the tibia, or shinbone. The first screw goes into this oval-shaped hole in the plate towards the top. This way, when the screw is fully inserted and starts to squeeze on the plate, the plate shifts up since the screw head wants to settle in the middle of the hole, compressing the front of the ankle joint and helping with the healing process.
This next screw compresses the back of the joint. It is drilled on an angle through this hole in the plate and goes all the way through both the tibia and talus. At this point, the plate is stable, and the bones will not move. For extra security, the rest of the holes can be filled with screws to maximize the strength of the plate against the bones.
The surgeon will take final x-rays to show that the plate and screws are in a good position. The skin incision is closed with sutures and the patient heads to the recovery room.