Artikel
Instability of the upper ankle joint following total ankle replacment solved with a plastic castaing procedure
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Veröffentlicht: | 13. Juni 2005 |
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Gliederung
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Summary
The posttraumatic osteoarthritis of the upper ankle joint is increasingly treated by a total joint replacement. The patient we are reporting about presented an additional complex injury of the fibulotalar ligaments. In primary surgery by total ankle replacement this was not solved sufficiently. Consecutively a fibulotalar instability with subluxation of the mobile polyaethylen inlay was the result.
As a salvage procedure during revision a plastic reconstruction by the Castaing procedure has been carried out. The clinical result six months post-operatively shows a very good mobility with fibulotalar stability. Total joint replacement of the upper ankle joint with a comminuted fibulotar ligament complex is possible but plastic reconstruction shoul be obtained initally.
Question
Does outdated tearing of fibulotalar structures accompanied with injury of the tibiofibular syndesmoses represent a contraindication for the total ankle replacement of the upper ankle joint?
Methodology: Primary surgery took place using an uncemented implant via a ventral
Approach. The implant has a mobile polyaethylen. Secondary plastic revision surgery took place one week later.
Results
Six months post operatively the patient was examined clinically and radiologically. Clinically outcome was evaluated with the the Koefoed Score. point Praeoperativ 27 points were rising to post-operatively 93 points. Tibiotalare opening angle was 8° and the anterior talus tilt was 5mm examined in the Scheuba -device.