Arthroscopic ankle fusion Case for small group discussion AOTrauma—Foot & Ankle Module 7: Ankle arthritis Christina Kabbash, US

Case description 63-year-old man with a history of rheumatoid arthritis (RA) Active hiker, farmer Varus hindfoot on the left Valgus hindfoot on the right Ankle ROM: 0o dorsiflexion; 20o plantar flexion Normal subtalar ROM Some neuropathy of the distal 1/3 leg Considerations: if fuse – ROM: range of motion

Preoperative x-rays

Preoperative planning Considerations: Mild deformity Good bone stock Poor skin envelope due to RA medications Age and activity profile suggest not a good candidate for total ankle arthroplasty Arthroscopic ankle fusion—decreased size of incisions, better soft-tissue healing

1-year postoperative x-rays Comments: Fibula left intact Well reduced

1-year postoperative x-rays

Take-home messages Indications for arthroscopic ankle fusion: Younger patient Active Mild deformity Compromised soft tissues