Introduction
Ankle fusion, also known as ankle arthrodesis, is a surgical procedure that eliminates movement between the bones of the ankle joint. It is commonly performed to relieve pain caused by advanced arthritis or a severely damaged ankle joint. Traditionally ankle fusion was performed using plates and screws for fixation. However, the use of intramedullary nail known as Global Ankle Fusion Nail is gaining popularity among orthopedic surgeons.
History of Ankle Fusion Nail
The idea of using a intramedullary nail for ankle fusion was first conceived in 1990s. However, initial nail designs had limitations like lack of biomechanical stability. The Global Ankle Fusion Nail was invented and patented in 2005 after extensive research and design improvements. It is made of medical grade stainless steel and titanium alloy for strength and biocompatibility. Compared to plates and screws, the nail offers improved stability of ankle fusion and faster rehabilitation.
Design features of Global Ankle Fusion Nail
The nail has a streamlined shape and curvature designed to fit anatomically in the medullary canal of tibia and talus bones. It possesses unique design elements that provide firm fixation of ankle joint. The nail tapers distally to allow compression at fusion site. Multiple threaded holes along length allow locking screws to fix nail firmly within bones. Compression slots at both ends allow controlled compression across arthrodesis site during tightening of set screws.
Surgical technique of ankle fusion with nail
After administering spinal or general anesthesia, an incision is made on the front of ankle. Bones are prepared by removing cartilage at fusion site. Nail of appropriate size and length is inserted from the tip of the talus bone and advanced into medullary canal of tibia bone. Guide wires are inserted through nail holes and foot is adjusted in desired alignment. Locking screws are used to secure nail within bones under fluoroscopic guidance. Incision is closed in layers with stitches or staples.
Post-surgical rehabilitation and recovery
Patient is allowed toe-touch weight bearing walking with the help of crutches or walker. Range of motion exercises are started for ankle, knee, and hips. Stitch/staple removal is done after 2 weeks. Periodic x-rays are taken to check fusion progression. Full weight bearing is allowed once fusion is seen on x-rays, usually within 3-6 months. Most patients return to regular activities within 6-9 months following ankle arthrodesis with nail.
Advantages of ankle fusion with Global Ankle Fusion Nail
– Stable compression across joint provides enhanced stability during fusion.
– Less soft tissue dissection compared to plates/screws leads to faster healing.
– Risk of implant failure or loosening is reduced due to locking screws and interlocking spikes feature.
– Allows early motion of nearby joints critical for improved function.
– Cosmetically pleasing incision leaves almost no skin scarring.
– Accelerated recovery time and postoperative rehabilitation.
Contraindications
Like any surgery, ankle fusion with intramedullary nail also has certain contraindications which includes:
– Active infection at surgical site.
– Lack of bone stock due to trauma or previous procedures.
– Systemic disorders affecting bone healing like diabetes, smoking etc.
– Neurological conditions reducing ability to follow postoperative care instructions.
Complications
Though a safe procedure, it can be associated with certain perioperative and postoperative complications like:
– Damage to nerves and blood vessels during surgery.
– Wound infection, delayed/non-union of bones at fusion site.
– Implant failure or loosening requiring revision surgery.
– Premature fusion resulting in further loss of ankle movement.
Overall, With its unique design providing rigid fixation, Global Ankle Fusion Nail has evolved as a standard implant for ankle arthrodesis in many countries. Its advantages of stability, early rehabilitation and predictable fusion rates have made ankle fusion a viable surgical option for end-stage ankle disorders. Further advancements in design aiming at faster fusion and improved patient outcomes will augment its role in orthopedic practice.
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- Source: CoherentMI, Public sources, Desk research
- We have leveraged AI tools to mine information and compile it