Principles of Arthrodesis
Introduction
Most reliable operation for pain or instability where stiffness does not seriously affect function, e.g. spine, tarsus, ankle, wrist, & inter-phalangeal joints.
Arthrodesis may be
- Intra-articular
- Intra-articular & extra-articular
- Extra-articular
Choice will depend on patients age, pathologic process & presence or absence of gross deformity.
Principles
- Exposure
- Good exposure whilst care not to over devascularise bone
- Preparation
- Denude joints
- feather subchondral bone
- add bone graft in larger joints
- Coaptation
- Surfaces are apposed in optimal position
- Fixation
- surfaces held rigidly
- protect until union
- Main complication is pseudarthrosis