Arthroscopic Ankle Fusion surgical technique
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Learn the Arthroscopic Ankle Fusion surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Arthroscopic Ankle Fusion surgical procedure.
An arthroscopic ankle fusion probably has consistently the highest union rate of any ankle fusion technique. It is often associated with low levels of short-lived post-operative pain and if bone quality is good there is the possibility of early limited weight-bearing in compliant patients. Union rates in excess of 90% are normal and much of the post operative period can be spent in a post-operative boot rather than cast given the inherent stability of the maintained (as opposed to flat cut) articular surfaces.
The technique is particularly useful for cases with poor soft tissue quality such as areas covered with skin graft or various plastic surgical flaps or compromised wound healing capacity such as diabetics.
There is disagreement about its use in the presence of significant deformity though as long as the deformity is passively correctible there is little issue. Even a degree of fixed deformity of the arthritic ankle can be corrected by differential intra-articular resection/preparation of the joint surfaces.
In the presence of a mobile compensatory mid-foot and hind-foot a normal, or largely normal, gait pattern can be expected following arthroscopic ankle fusion. Appropriate patient selection is important and in-particular considering fusion carefully in those with pre-exisiting sub-talar or midfoot arthrosis which will deteriorate in many cases. These are the same considerations though for any ankle fusion irrespective of technique.
One should be fully conversant with the technique of ankle arthroscopy before attempting an arthroscopic ankle fusion. This technique is covered on OrthOracle at Ankle arthroscopy using the Smith & Nephew Guhl non-invasive ankle distractor
Alternative techniques to fuse the ankle should always be in a surgeons skill set and examples can be read on OrthOracle at Open ankle arthrodesis using Ankle Fix 4.0 plate (Zimmer-Biomet) and Open ankle fusion: Trans-fibular approach.
Author: Mark Herron FRCS.
Institution: The Wellington Hospital, London, UK.
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- The operative technique itself is read as a lesson as is any company implant information if this is being assessed.
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- There are additional quiz modules on the surgical steps, the implants and problem cases being added continually
- The course is completed once all the lessons are read and quizzes submitted and passed.
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- The timer suspends after 5 minutes though if there is no activity.
- When you restart you will resume at the same point in the module.
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The pass mark is 75%.
- If you fall below this level you will be directed back to re-read the slides where you’ve tripped up.
- Once these have been read you can re-do just the questions you failed on.
- Once you have passed the quiz you can return at a future stage & resit .
- Operation Quiz – 1 CPD point
- Surgical steps Quiz – 1/4 CPD point
- Implants Quiz – 1/4 CPD point
- Problem case Quiz – 1/2 CPD point
One CPD point equates to one hour of academic activity
Welcome to the Professional Development question section. The objective of taking these tests is to demonstrate that you have understood all aspects of the assessment and management of patients requiring surgical intevention. On successful completion you will receive a certificate accredited by both the Royal College of Surgeons of both England and Edinburgh as well as the British Orthopaedic Association.
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