Contemporary understanding of managing the patients with consequences of ankle injuries by arthrodesis (review)

Introduction. The management of patients with the consequences of ankle injuries is a crucial issue due to the constant worldwide increase in the incidence of this pathology within the population, a large number of complications and poor outcomes of surgical rehabilitation, and thereby frequent disabilities.

The aim of this research was to analyze the current state of the problem of managing patients with consequences of ankle injuries by arthrodesis through Russian and foreign experience.

Material and methods. We reviewed the articles retrieved mostly from the electronic databases (Medline, PubMed, eLIBRARY, Cochrane, SpringerLink, and Web of Science) by keywords ankle fractures, arthrodesis, intra-articular tibial fracture, ankle joint, post-traumatic osteoarthritis, crusarthrosis.

Results. The study features the aspects of contemporary understanding of managing the patients with consequences of ankle injuries. The most common adverse outcome of the ankle injuries management is post-traumatic crusarthrosis (up to 60%). We present the descriptions of surgical interventions used to treat post-traumatic crusarthrosis as well as ankle arthrodesis options (compressive and non-compressive, arthroscopic arthrodesis) as the "gold standard" in the treatment of this pathology. The positive and negative aspects of the surgical methods are outlined, and unresolved issues are highlighted.

Discussion. Arthrodesis of the ankle joint is recognized by most authors as the "gold standard", however, some issues remain controversial and yet unresolved. The need to treat tibia and talus articular surfaces, use osteoplastic materials, remove the articular cartilage as well as the methods of fixation in arthrodesis and others are discussed, but all authors point to the indisputable advantages of ankle arthrodesis: its efficacy, ease, reproducibility and low cost of the method.

Conclusion. Despite some unresolved issues, ankle arthrodesis is an effective surgery for post-traumatic stage III-IV ankle osteoarthritis.

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