Ankle arthrodesis with cross-screw fixation. Good results in 36/40 cases followed 3-7 years

Tibiotalar arthrodesis by an anterior approach, using internal compression with cancellous screws, offers wide exposure, good possibilities of correcting deformities, and good bony apposition. From 1987 to 1991, we used this technique in 42 ankle joints (40 patients). The indications were posttraumatic arthrosis, rheumatoid arthritis, neurogenic paralysis, sequelae of septic arthritis, necrosis of the talus and failed ankle arthrodesis. In 13 ankles with severe deformity, a bone graft was also used. 38 patients (40 ankle joints) were available for follow-up after 4 (3-7) years. Solid union was achieved in 38 ankles after an average of 13 weeks. The clinical result was good-to-excellent in 36 ankles. We conclude that this is a simple and effective method for ankle arthrodesis in both low-risk and, coupled with bone grafting, in properly selected high-risk patients.