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S34 ANKLE ARTHRODESIS IN RA – A COMPARISON BETWEEN RETROGRADE NAILING AND COMPRESSION SCREWS

Lund

25 RA patients with their ankles fused with an intramedullary nail were compared to 35 RA patients with their ankles fused with compression screws.

24/25 nailed patients showed radiographic healing at follow-up after 3 (1–8) years, and 26/35 ankles in the compression screw group examined after 6 (1–14) years healed after the first attempt and another 5 after repeat surgery.

In the nailed group 23 patients were satisfied and 2 somewhat satisfied. In the compression screw group 20 were satisfied, 12 somewhat satisfied and 3 dissatisfied.

There were 4 deep infections (3 healed after nail extraction and antibiotics, one unhealed) in the nail group and 1 deep infection (healed after antibiotics) in the compression screw group.

Six patients in the nailed group also had a permanent plantar sensory loss.

Conclusion: Ankle fusion with retrograde intramedullary nailing seems to result in a high rate of healing and satisfied patients, but cares a substantial risk of deep infection compared to fusion with compression screws, which has a lower fusion rate fewer satisfied patients, but less complications.

RA patients with a normal subtalar joint are of course only managed by compression screws.

Correspondence should be addressed to ERASS Office, Schulthess Klinik, Lengghalde 2, CH-8008 ZURICH, Switzerland.