Definition of Arthrodesis | CHAPTER 10 | Orthopedic Nursing
Definition of Arthrodesis – An orthopedic nurse is a nurse who specializes in treating patients with bone, limb, or musculoskeletal disorders. Nonetheless, because orthopedics and trauma typically follow one another, head injuries and infected wounds are frequently treated by orthopedic nurses.
Ensuring that patients receive the proper pre-and post-operative care following surgery is the responsibility of an orthopedic nurse. They play a critical role in the effort to return patients to baseline before admission. Early detection of complications following surgery, including sepsis, compartment syndrome, and site infections, falls under the purview of orthopedic nurses.
Arthrodesis is the surgical methods in which joint surface are excised and raw bony ends are fused together to eliminate the existing joint.
[Ref-SRBs, Surgery for nurses, P-441]
Or
Arthrodesis is fusion of the joints by surgical methods which limits the function of the joint. In operations upon joints, arthrodesis means that the joint is fused.
[Ref-John Ebnezar’s, “Orthopedics for Nurses”, 4 edition, P-391]
Or
Arthrodesis, also known as artificial ankylosis or syndesis, is the artificial induction of joint ossification between two bones via surgery.
Arthrodesis is used in the following situations;
1. Gross destruction of the joints. E.g. Rheumatoid arthritis, Charcot’s joints advanced osteoarthritis.
2. Quiescent tubercular arthritis.
3. Gross instability due to muscle paralysis as in polio.
4. For permanent correction of the deformity.
5. Severe foot/ankle deformity.
6. Arthritis.
7. Instability and skeletal defects after tumor resection; these include, but are not limited to, neuro- osteoarthropathy (Charcot’s foot).
8. Avascular necrosis of the talus.
9. Failed joint replacement or failed ankle fusion.
10. Distal tibial fracture nonunions.
11. Osteoarthritis.
12. Rheumatoid arthritis and pseudoarthrosis.
Spinal deformity
[Ref-John Ehnezar’s, “Textbook of Orthopedics”, 4″ edition]
Methods of arthrodesis:
There are three methods of arthrodesis, These are given bellow:
1. Intra-articular arthrodesis: Here joint is opened, articular cartilage is denuded, cancellous bone grafts are packed and joint is kept in a functional position and either fixed internally or externally by plaster.
Meta carpophalangeal joint refashioned by can cancellous bone graft
2. Extra-articular arthrodesis: This is indicated in infective condition of the hip, shoulder or spine, knee. In this, there is no risk of reactivating or spreading the infection as the joint itself is not opened, but bone to bone fusion is obtained above or below the joint.
3. Combined arthrodesis: This is the combination of the above two procedures
Lumbar intervertebral fusion
[Ref-Ebnezar’s, “Textbook of Orthopedics”, 4 edition, P-369,370]
Functional positions of arthrodesis:
Each joint should be fixed in its functional position as mentioned below to enable the patient to continue using it:
[Ref-John Ebnezar’s, “Textbook of Orthopedics”, edition, P-370]
Complications of arthrodesis:
1) Non-union
2) Formation of pseudoarthrosis.
3) Rigid fixations
4) Limitation of joint movements
5) Bony parts are squeezed together.
[Ref- Apleys, System of orthopaedics and fracture, 9 edition,324]
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Risks of arthrodesis:
The risk associated with joint fusion surgery depending upon the persons age, overall health status, and type of procedure that is being performed.
1) Pain at the site of bone fusion
2) Failure of the fusion
3) Nerve injury.
4) Infection.
Common Arthrodesis done in orthopaedic surgery unit:
