Charnley, J Bone Joint Surg Br 1951 - Compression Arthrodesis of the Ankle and Shoulder

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Compression Arthrodesis of the Ankle and Shoulder

Charnley·J Bone Joint Surg Br·1951·310 citations·Case series

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Charnley tested whether direct bone-to-bone compression, extended from his knee technique, reliably achieves ankle and shoulder arthrodesis without bone grafting. Technique description with early case series: ankle arthrodesis (n=19) and shoulder arthrodesis (n=4) by transfixing pin compression, assessed by clinical function and radiographic union.

Key Findings

Ankle: excellent functional result in 18 of 19 cases. 4 united fibrously rather than by bone but functioned like solid fusion, and all 4 traced to technical error (pin-split tibia or poor surface apposition).
Radiographic trabecular continuity across the ankle fusion took at least 6 months to appear. Absence of sclerosis at 6 months indicated osseous union.
Shoulder (n=4): all patients actively elevated the arm at pin removal at 4 weeks and held a 5-pound weight at 10 weeks.
Charnley attributed success to compression eliminating shear at the bone interface, giving primary healing, and argued bone grafts add little because osteogenesis comes from living host bone.
Significance: Charnley extended compression arthrodesis from the knee to the ankle and shoulder, establishing that stable interfragmentary compression without grafting can achieve fusion and defining a functional shoulder fusion position.

Board PearlCharnley's shoulder arthrodesis position is about 45 degrees abduction and 45 degrees forward flexion from the coronal plane, with the forearm about 45 degrees above horizontal.

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Compression Arthrodesis of the Ankle and Shoulder

Charnley·J Bone Joint Surg Br·1951·310 citations·Case series

|

Charnley tested whether direct bone-to-bone compression, extended from his knee technique, reliably achieves ankle and shoulder arthrodesis without bone grafting. Technique description with early case series: ankle arthrodesis (n=19) and shoulder arthrodesis (n=4) by transfixing pin compression, assessed by clinical function and radiographic union.

Key Findings

Ankle: excellent functional result in 18 of 19 cases. 4 united fibrously rather than by bone but functioned like solid fusion, and all 4 traced to technical error (pin-split tibia or poor surface apposition).
Radiographic trabecular continuity across the ankle fusion took at least 6 months to appear. Absence of sclerosis at 6 months indicated osseous union.
Shoulder (n=4): all patients actively elevated the arm at pin removal at 4 weeks and held a 5-pound weight at 10 weeks.
Charnley attributed success to compression eliminating shear at the bone interface, giving primary healing, and argued bone grafts add little because osteogenesis comes from living host bone.
Significance: Charnley extended compression arthrodesis from the knee to the ankle and shoulder, establishing that stable interfragmentary compression without grafting can achieve fusion and defining a functional shoulder fusion position.

Board PearlCharnley's shoulder arthrodesis position is about 45 degrees abduction and 45 degrees forward flexion from the coronal plane, with the forearm about 45 degrees above horizontal.

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