Arthrodesis of the ankle joint
Arthrodesis of the ankle joint is a fairly complicated surgery, the goal of which is the complete elimination of the possibility of movement of the ankle joint. While motor function is often lost due to such reasons as injury, arthritis, distortion, torn syndesmosis, tuberculous arthritis, fractured bones, malunion and other injuries. Treatment the implementation of fusion in essence is the fusing of bones that are close, or the formation of bony ankylosis. The implementation of the arthrodesis provides recovery support ability of the limb.
What are ankle
Damage to the ankle joint perhaps the most common injury of the lower limb. The reason is that virtually any movement of people leads to joint loads at least equal to the weight of his body. On the incidence of injuries of this joint is affected by the biomechanics of articular motion. Thus, plantar flexion leads to subluxation of the foot towards the outer side, and the total flexion may end with the same result, but directed inward. A consequence of the excessive load and becomes a trauma.
Among the many damages that can test the ankle, the most common are the following:
- a fracture of the ankle;
- distortion of ligaments;
- partial rupture of ligaments;
- fractures of the tarsal bones;
- a torn syndesmosis in the ankle;
- fracture of the calcaneus.
Getting such damage is almost always accompanied by the same type of symptoms, which include:
- sharp pain in ankle joint;
- the swelling in the joint area;
- painful feelings that accompany any movement of the foot;
- pain the entire leg;
- deformation in the joint;
- some flattening of the foot;
- difficulties with walking, and sometimes the impossibility of carrying out movements of the foot;
- occurs when a feeling of pain;
- localization of pain below outer ankle on palpation.
The most common ankle injury is common in athletes. While some of these injuries are quite complex and require skilled care. Often, however, the damage is not very serious, and they can cope on their own. For example, a bruise of the ankle joint pass itself, but fixation of the tibia and the use of some medical devices to help cope with the trauma much faster.
If you got even a slight injury, after which the joint is swollen and hurts, it is better to consult a doctor to receive necessary treatment and to prevent possible problems.
Rupture of the syndesmosis and distortion
The syndesmosis of the lower leg is a compound bone interosseous membrane a membrane that fills a rather large gap. A leg injury sometimes leads to the fact that the syndesmosis is torn. If a joint is swollen, there was pain, and the Shin bone excessively mobile, it can be assumed that the torn syndesmosis.
A damaged syndesmosis is typically crosslinked, and the bones are fixed with screws or screws. Previously used osteosynthesis tie bolt, but today this operation is practically non-existent. Torn syndesmosis after surgery may heal up to six months, after which the screws or bolts are removed. In General the torn syndesmosis quite well, although not quickly treated.
Any, even the most minor trauma of the lower leg can lead to a distortion, which is the stretching or even tearing of ankle ligaments. Usually distortion occurs as a result of sudden movements of the foot in an unusual direction or increased volume. If after this movement the joint is swollen, there was a sharp pain, it can be assumed tensile. The distortion is usually treated with conservative methods, but sometimes it is accompanied by various complications.
The repeated injuries of ligaments may develop so-called loose joints, to cure which is sometimes possible only by the operation of arthrodesis.
Indications for surgery
Arthrodesis of the ankle joint is made in order to avoid soreness in his ankle caused by:
- certain diseases;
- wrong fusion after the fracture;
- a defect of development;
- any orthopedic diseases.
Quite often the reason for this operation is injury or distortion. This disease of the ankle joint, as deforming arthrosis can be an indication that the treatment exactly the arthrodesis. Note, however, that recourse to this procedure should only be at the final stages of the disease accompanied by obvious pain. The reason for the development of deforming arthrosis can be bone injury, avascular necrosis, torn syndesmosis, articulate inflammatory disease or systemic failure of cartilage.
When planning treatment, it is important to assess the condition of other joints nearby because the load on them after surgery will increase quite markedly. So, it is very important the condition of the talus-navicular joint: it will have a major increase of the load. Treatment can bring a positive outcome only in the absence of degenerative changes in this joint. Otherwise, the effects of the operation are difficult to predict.
Regardless, diagnosis of the disease of the ankle joint, for medical assistance to determine the need for spinal fusion, you should refer to when identifying the following symptoms.
Of course, not always this operation will be necessary in the presence of these signs. After all, they are typical of many injuries. But at least think and give the treatment necessary.
If the ankle injury has led to the fact that the bone was cracked and in addition to these signs of the tumor, you make the decision about the need for surgery will only experienced doctor.
The implementation of fusion
Before the implementation of the operation should conduct a thorough examination of the patient, to determine its General condition and identify any risk factors. In some cases, arthrodesis of the ankle joint may not be necessary. Sometimes treated with non-surgical procedures allows you to fix a number of problems. Proper and timely treatment can cope with such problems as minor trauma, the distortion, the torn syndesmosis and fracture of the bone.
If the decision about the necessity of the arthrodesis, the patient should prepare for surgery. For this about a week before the appointed time, discontinue treatment and krivorozchskiy any anti-inflammatory drugs. The day before surgery, the patient will have to take very light food, and on the day of the arthrodesis meal is completely contraindicated. You also need to prepare the apartment for the return of the person operated on from the hospital and give him access to the bathroom, and necessary items.
The operation is performed under anesthesia which may be General or spinal. The blood supply to the leg during the operation is limited to the imposition on thigh harness – it provides the bleeding of the incision site. Gotowanie for a short time does not lead to negative consequences.
The surgical process is a long incision to access the joint, after which it is sealed. Today there are many ways of connecting bones with a full limit of their movement relative to each other. For this purpose, steel rods, long bolts, a steel plate with screws and bone grafts.
The duration of the operation does not usually exceed two hours, but it all depends on the severity of the individual case.
The rehabilitation period
Recently developed techniques that allow not to fix Shin plaster or other additional fasteners. However, this does not negate the need to find a patient in the hospital for four to five days after surgery. Directly after the arthrodesis the patient is placed in a chamber where the lower leg is suspended and injected painkillers.
|The day after surgery.||If the state operated allows, allowed him the movement of the crutches with no load on the limb subjected to surgery.|
|During the following 8 weeks.||After this period is made by radiography, the results of which the patient may be allowed to partially load the operated limb. Simultaneously, begin physical therapy sessions that strengthen muscles and increase range of motion.|
|Through ten weeks.||As a rule, you are allowed a increase in physical activity. Alas, but quickly increase the motor activity is not always. Be sure to use special shoes that support the foot or orthosis.|
If, after the movement that the joint is swollen, there was pain – it is recommended to limit movement for a few days. We have to wait for the relief of symptoms. You can then continue the rehabilitation of a modest pace.
Foot function is usually restored satisfactorily within six months after the operation, but for maximum recovery may require longer treatment, lasting up to a year and a half.