Ankle Surgery

If you have ankle pain, your doctor may recommend surgery. This is usually an option when more-conservative treatments don’t help.

Ankle surgery Beenleigh the damaged joint with a metal and plastic artificial joint that mimics the natural movement of your ankle. Recovery is typically three to six weeks in a cast and physical therapy.

Anterior Approach

Ankle arthrodesis is a mainstay of treatment for end-stage ankle arthritis because it is relatively straightforward, is safe, and provides effective results. Several surgical approaches are available, including the anterior, transfibular, and posterior methods.

The anterior approach allows excellent exposure to the ankle joint and is easy to correct for coronal plane deformities. However, the anterior approach may cause injury to neurovascular structures such as the tibial nerve (SPN) and dorsalis pedis artery if not performed correctly.

To avoid these complications, a thick mobile skin flap should be created carefully during the superficial dissection to protect both the SPN and the dorsalis pedis arteries. In this manner, the surgeon can perform the arthroscopic procedure safely and efficiently.

Posterior Approach

The posterior approach has become increasingly popular for the management of ankle fractures. This technique facilitates accurate reduction of the posterior malleolus, which is essential for syndesmotic stability and optimal contact pressure within the ankle joint.

Traditionally, fractures of the posterior malleolus were managed indirectly by buttress plate fixation. However, this procedure has become less effective as fragments decrease in size and as articular displacement increases.

Posterior malleolus fractures have always been more difficult to reduce than their medial or lateral counterparts due to their location. This problem has prompted surgeons to avoid the open approach for these fractures.

Several cadaveric studies have demonstrated that the posterior approach can be a safe and effective treatment for posterior malleolus fractures. These studies showed that the posterolateral approach yields better outcomes than A to P screw fixation in patients with Bartonicek type II and III fractures.

Transfibular Approach

The transfibular approach to ankle surgery involves a vertical incision on the outer side of your ankle. Your surgeon removes cartilage from the bottom portion of your fibula and then aligns the other ankle bones and fuses them together using screws or plates.

This procedure is associated with a high rate of fusing and a better outlook than the anterior approach. It also allows your surgeon to see the joints better.

We performed arthroscopic ankle arthrodesis under this approach in 8 patients with valgus ankle arthritis. All were able to achieve appropriate tibiotalar alignment through this approach.

The lateral half of the sagitally split distal fibula was preserved, which provided additional lateral support for the fusion and significantly improved the union rate. In addition, the lamina spreader provided an excellent exposure of the articular surfaces, which resulted in a satisfactory resection of articular cartilage and minimum subchondral bone.

Open Ankle Fusion

The open ankle fusion approach to surgery removes damaged cartilage and fuses the two main bones of your ankle joint (tibia and talus) together using metal screws and shaped plates. The operation can also involve some bone grafting, either from your own hip bones or from donor bone, to help with the healing process.

Ankle fusion is often recommended to people with osteoarthritis or arthritis of the ankle. The procedure also helps to reduce pain and swelling.

During the operation, your surgeon makes a horizontal incision across the front of your ankle. The two main ankle bones are placed in the correct position and then fixed together with screws and shaped plates.

X-rays are usually taken at around 3 months after surgery to check the fusion is healing. If all is well, no further plaster casts are needed and you can walk normally. If the fusion has not healed, then you'll need to wear a plaster cast for another 6 weeks.

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