Distraction-Compression Bone-Graft Arthrodesis of the Ankle

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Abstract
A technique for ankle arthrodesis is described, along with the indications for this procedure, and the results obtained in twenty-one patients are presented. A full-thickness iliac graft is inserted between the denuded horizontal surfaces of the tibia and talus, effecting a compression arthrodesis by the pressure produced by distraction of the denuded joint surfaces. This "distraction-compression" graft is a reliable method for arthrodesis of the ankle, and its use should be considered especially in children with open epiphyses. The advantages of this procedure are: 1. Arthrodesis of the ankle can be performed in the growing child without any risk of disturbing growth. 2. In paralytic patients more years of freedom from bracing are gained by doing the fusion in childhood. 3. Length of the limb is preserved or increased from the height of the graft and the equinus position produced by the graft. 4. The proved principle of compression is made applicable in a joint which does not readily lend itself to compression. 5. The procedure is universally applicable, in adults as well as children.

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