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 Kuntscher
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.