Ankle arthrodesis. Problems and pitfalls

Compression ankle arthrodesis remains a widely accepted surgical procedure. However, uniform efficacious results are not always obtainable. Seventeen patients treated by compression ankle arthrodesis showed 11 fusions, or a 65% union rate, with an average immobilization period of five months. The nonunion group of six patients (35%), with an average of ten months of immobilization, included two patients who were treated by below-knee amputations. The failures demonstrated basic violations of surgical, roentgenographic, and biomechanical tenets. In particular, the commonly used external fixation devices afford stability in only one plane and do not give rigid immobilization. A Triangular Compression Device solves these problems and has been used successfully.