Abstracts Posters SICOT-SOF meeting Gothenburg 2010 _2_

Poster
Topic: General Orthopaedics
Abstract number: 25859
ANKLE ARTHRODESIS USING ACETABULAR REAMER TO HARVEST FIBULAR
BONE GRAFT
Mahmoud HAFEZ 1 , Ahmed ELMORSY 1 , Amr Mohsen ALI 2
1 The Orthopaedic Unit, October 6 University, Cairo (EGYPT), 2 Sheikh Zayed
Specialized Hospital, Cairo (EGYPT)
Bone grafting is usually required to enhance bone fusion in ankle arthrodesis. Bone
from iliac crest provides an ideal bone graft material but the use of iliac crest is an
additional surgical procedure and has its own morbidity. A simple technique for
harvesting cancellous bone from the lateral malleolus is described here. After
exposure of the lateral malleolus, the outer aspect of the bone is cleared of soft
tissue attachments. A small size (38 or 40 mm) powered acetabular reamer is used
to harvest cancellous bone. The outer cortex of the malleolus can be stripped to
expose the cancellous bone and facilitate the reaming technique. The malleolus is
osteomised and removed to expose the joint surface. The desired technique of ankle
fusion and of internal fixation are used with the harvested graft. The remaining part of
the malleolus can be used as a supplementary graft if needed. This technique saves
the time usually used to crush the osteomised lateral malleolus. Also, the osteotomy
of lateral malleolus creates a better cosmetic result as it narrows the ankle and
prevents bony abutment on the shoe. The technique was used in a 35-year-old male
who had an old trauma resulted in a severe osteoarthritis of his left ankle and a
traumatic fusion of the subtalar joint. A transfibular lateral approach was used and
the above described technique was applied. The ankle was fixed using 2 cross
screws, we did not encounter any complications and the outcome of this procedure
was satisfactory.
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