Description
In this insightful presentation, Dr. Charles Saltzman discusses the complexities surrounding failed ankle arthrodesis, providing an overview of complications such as union and non-union rates based on his experiences and data analysis from a sizable cohort. He emphasizes the importance of understanding the incidence of failures, reporting about a 9% failure rate and discussing factors that contribute to both primary and revision cases. Dr. Saltzman elaborates on various treatment strategies, including the use of improved fixation methods and biological enhancements such as bone morphogenic proteins (BMP) and iliac crest grafts to optimize healing.
Throughout the talk, he addresses common issues that arise with delayed unions and reviews successful case examples of nonunion treatment, highlighting the significance of modifying patient factors like blood glucose levels and tobacco use on surgical outcomes. Dr. Saltzman also touches on the importance of infection management, outlining approaches to rule out deep infections with serological tests and culture evaluations.
In relation to malunions, the speaker introduces techniques to correct angular deformities and emphasizes the need for careful planning, especially in cases with more complex anatomical challenges. He also alludes to the potential of total ankle replacement for select patients, citing emerging literature that supports this approach. The presentation concludes with a call for further research in this area, ushering a dialogue about the advancements in surgical techniques to enhance patient recovery post-ankle fusions.