Arthrodesis with Locking Nails

Fusion of the knee joint is the treatment of choice, if prosthetic reconstruction of the joint is not possible. In the past, arthrodesis with a long Küntscher nail was used to treat elderly patients with fractures (Fig. 9.1). This method is described as an exceptional operation by Arens, Beck, Lentz, Maatz and collaborators [9], and pupils of Küntscher [8]. Other methods are recommended for arthrodesis: for example, the external fixator is used by Blauth [2], Hessmann [7], Müller [10], Friedebold [2, 6], and many others. Blauth introduced compression arthrodesis with two plates. The Küntscher method was modified by Maatz [9] and Chapchal [3]. These authors performed knee arthrodesis with a short Küntscher femur nail. Cheng used a similar technique with a short locked intramedullary nail [4]. Arthrodesis with the intramedullary nail is more comfortable for the patient. It is described by Puranen [11] and Vidal [14], who prefer the intramedullary technique, as do Vander Griend [13] and Alt [1].