The Results of Arthrodesis of the Ankle for Leprotic Neuroarthropathy

Twenty-four patients who had arthrodesis of one or both ankles for leprotic neuroarthropathy were followed for an average of nine years and five months. At operation, after the removal of cartilage, joint debris, and sclerotic bone, the ankle joint was transfixed with a Küntscher intramedullary nail, and staples or Kirschner wires were used to control rotation. Fusion of bone was obtained in nineteen (73 per cent) of the twenty-six ankles. Failure to obtain fusion was due to postoperative infection in four patients, deficiency of the site of arthrodesis in one patient, and refracture through the site of fusion in two patients. When arthrodesis was successful, additional neuroarthropathic destruction of the mid-tarsal joint was halted, and the preoperative clinical symptoms of dull pain, local warmth, swelling, and instability were relieved.