[Tibiotarsal arthrodesis in a septic milieu].

The authors have performed 28 ankle fusions for septic causes. There were 23 cases of septic arthritis and 5 severely comminuted compound fractures treated by primary fusion. Arthrodesis was made after wide excision and stabilization by external fixator. In 23 cases secondary bone grafting was done. Only in 13 cases was a satisfactory contact between the bony surfaces obtained. There was no contact at all in 9 cases. The authors have had good experience with the A.L.J. model of external fixator. On 7 occasions, secondary grafting was made using a cortico-cancellous graft with 3 failures. On 6 occasions, the Papineau technique was used with success but healing was slow. Out of 24 patients, the final result was good in 18 with 4 failures of fusion and 3 persistent sinuses. The importance of a wide excision is emphasised leading to the need for the use of external fixation. In cases of skin loss in recent comminuted fractures, the Papineau method is indicated as a primary procedure.