Headless compression screw fixation prevents symptomatic metalwork in arthroscopic ankle arthrodesis

Abstract Background Arthroscopic ankle arthrodesis (AAA) is a recognised salvage procedure for end-stage arthritis. Its reported disadvantages include a high rate of re-operation for symptomatic prominence of metalwork. We propose that the use of a headless screw would reduce this re-operation rate. Methods We reviewed 32 AAAs, using the Acutrak™6/7 mm headless screw fixation system, to determine peri-operative parameters and complication rates. Results At an average of 22 months follow-up, 28 (88%) had united radiologically. There were 2 stable fibrous non-unions not requiring further intervention. Of the other 2, one was successfully revised using an open technique, and the other patient died of unrelated causes. There were no other complications in this series, with no cases of metalwork removal for prominence or pain. Conclusions Using a headless screw fixation for arthroscopic ankle arthrodesis prevents symptomatic metalwork prominence and the requirement for removal.