A functional assessment of twelve patients after ankle arthrodesis for
post-traumatic arthritis was carried out by means of an extensive clinical
evaluation and gait analysis after an average follow-up of eight years. A
weighted point system was developed to grade ankle function clinically. The
data on gait analysis were examined to determine the effect of arthrodesis
of the ankle on the over-all pattern of walking. Under conditions of normal
daily living while wearing shoes, all patients functioned well after
arthrodesis. The gait-analysis data obtained with the patients wearing
shoes showed excellent gait characteristics, and the ankle motion that had
been lost was compensated for by: (1) motion of the small joints of the
ipsilateral foot; (2) altered motion of the ankle in the contralateral
limb; and (3) appropriate footwear. While the patients were walking
barefooted, some adverse effects of fusion of the ankle were evident.
Velocity of gait was slowed and the length of stride was shortened in all
twelve patients. One patient whose ankle had been fused in an equinus
position had a back-knee deformity during stance phase, and another walked
only on his toes when he was without shoes. The gait patterns of all
patients were markedly improved when they were wearing shoes with
appropriate heel heights.