The slot graft technique for foot and ankle arthrodesis in a high-risk patient group

Background: High rates of arthrodesis nonunion have been described in the ankle, hindfoot and midfoot in patients with significant risk factors. The purpose of this study was to evaluate fusion rates, risk of reoperation, postoperative pain scores and patient satisfaction for a slot graft inlay arthrodesis technique used in a high-risk group of foot and ankle patients. Materials and Methods: We retrospectively reviewed all ankle, hindfoot and midfoot arthrodeses by two foot and ankle surgeons in our institution between January 2000 and January 2009. Seventeen arthrodesis procedures in 16 patients using the slot graft technique were identified. Patient charts were reviewed for medical history, risk factors, previous surgery and postoperative complications. Time to union was evaluated on radiographs. Patients provided final followup by phone with an assessment of pain, overall satisfaction and use of orthotic or assistive devices. Results: Union occurred in 13 arthrodesis procedures (77%) with an average time to union of 5 months. Postoperative infection occurred in one patient. Additional surgery was performed in nine patients. At final followup patients reported low pain scores (3 of 10) and high satisfaction (8 of 10). Fourteen of 15 patients contacted indicated that they would choose to undergo the procedure again. Conclusion: The slot graft arthrodesis technique provided satisfactory results in this small group of patients with a low complication rate. Patient satisfaction rates were high with low pain scores at an average of 62 months postoperatively.