ARTHROSCOPIC TIBIO-TALAR ARTHRODESIS

Purpose of the study The authors describe an arthroscopic technique of tibio-talar arthrodesis. They discuss the advantages, indications and results of this technique. Material Seven arthroscopic tibio-talar ar throdeses (A.T.T.A.) were performed between may 1992 and september 199 3 for post traumatic arthritis (five following bimalleolar fractures, two following talar fractures). Method Traction by means of a transcal caneus pin was applied to obtain articular distraction. Arthroscopic d ebridement was performed using two standard anterolateral and anterome dial portals. The arthrodesis was secured in neutral position by two p ercutaneous tibio talar cannulated cancellous screws. Results Fusion w as obtained in all cases over an average period of 12 weeks. No infect ions or cutaneous complications were noted. In one case, however, scre w positioning caused an injury to a branch of the superficial peroneal nerve. At last follow-up, according to the Duquennoy grading system, the results were good or very good. Discussion In this study, we notic ed a particularly low rate of complications, a significantly lesser re covery time and a higher fusion rate compared to open ankle arthrodesi s techniques. This is probably due to the careful handling of the peri articular soft tissues, possible with the arthroscopic procedure. The best indication for this procedure seems to be << centered >> ankle ar thritis. However, a significant deviation in one plane, or a tibial or talar bone loss needing an autogenous graft is considered to be a con tra-indication for the procedure.Conclusion A.T.T.A. seems to be a sim ple and reliable technique for centered ankle arthritis.