LCP Anterior Ankle Arthrodesis

Per-Henrik Agren, Andrew Sands, Ian Winson, Michael Castro, Les Grujic, Juan Bernardo Gerstner Garcés

The LCP anterior ankle arthrodesis is indicated for arthrodesis of the ankle joint and distal tibia via an anterior approach. It is especially useful if a previous extensile approach was made for ORIF, making subsequent adjacent incision ill advised.

The plates are precontoured, have combination holes in the plate shaft and are available in 6-hole (100 mm) or 7-hole (116 mm) lengths. All holes accept 4.5 mm cortex, 4.5 mm shaft screws and 6.5 mm cancellous bone screws. The locking holes accept 4.0 mm solid, 5.0 mm solid or 5.0 mm cannulated locking screws. Two distal elongated DCU holes allow for greater screw angulation and better bone purchase. A proximal notch accepts the articulated tension device (to allow compression or distraction).

The plate is available in 316L implant quality stainless steel or commercially pure (CP4) titanium.

58-year-old male

Case provided by Andrew Sands, New York, USA

Previous plafond fracture and ORIF through large anterior incision. Increasing pain not relieved by nonoperative preoperative workup revealing deep bony infection. The interim procedure was deep biopsy, curettage and placement of antibiotic self-dissolving beads. Generation IV antibiotics were given. The reimaging showed infection had gone.

Anterior approach through the same anterior incision with placement of anterior plate. Orthogonal screw was added for stability through the fibula into the talar body. Preserving fibula makes it easier for future reconstruction should that be possible (ie, placement of implant in the face of previous infection currently not recommended).

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