Posterior Ankle Arthrodesis

Posterior ankle arthrodesis is suitable for patients with sacral ankle, ankle instability or joint destruction with plantar flexion and stiffness. The same incision can be used to complete the Achilles tendon extension, posterior tibial neurovascular release and joint fixation. Treating diseases: contraindications 1. Children under 14 years of age who are not mature. 2. Lower limbs sensory disturbance and neurotrophic abnormalities. 3. Severe foot varus deformity. Surgical procedure Incision Make a 10~12cm wavy incision along the posterior side of the Achilles tendon, down to the Achilles tendon. Open the deep fascia, free the Achilles tendon, insert the Achilles tendon with a tendon knife, occupy 1/2 of the front and rear, and open the Z-shape from top to bottom. Near the heel stop, the blade is turned 90° before the turn. 1/2 of the iliac crest, 1/2 of the posterior aspect of the incision. 2. Reveal the lower end of the humerus and the ankle joint Before and after the two halves, turn up and down, cut the fat cellulite, reveal the lower end of the humerus and the back of the heel. The flexor toe and posterior tibial tendon can be seen in the deep side of the incision, and the posterior tibial artery and nerve can be seen inwardly, paying attention to protection. The periosteum at the lower end of the humerus was dissected and peeled up and down to enlarge the ankle joint, the subtalar joint and the calcaneus. 3. Bone fixation First, a 4cm × 2cm bone piece was cut at the lower end of the humerus, the articular cartilage surface was removed, and a bone groove was drilled in front of the Achilles tendon. The bone piece was moved down, and the distal end was embedded in the bone groove to maintain the 90° neutral position of the ankle joint. One set of screws is fixed at the upper and lower ends of the sheet. Sward advocates fixing with screws from the back. The posterior approach and articular fusion of the lower ankle joint is used. The method is simple and reliable, the surgical trauma is small, the fusion rate is high, and the traumatic arthritis is used for internal and external fusion of the joint, otherwise the extra-articular fusion is performed. 4. Suture incision Rinse the wound, relax the tourniquet, stop the bleeding completely, and suture it in layers. Keep the ankle joint 90°, bend the knee 30°, and fix the long leg tubular cast.