A E Thomas1, P M Guyver2, J M Taylor3, M Czipri4, N J Talbot5, I T Sharpe6. 1. Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, United Kingdom. Electronic address: aet81@hotmail.com. 2. Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, United Kingdom. Electronic address: Guyver@hotmail.com. 3. Radiology Department, Level 6, Derriford Hospital, Plymouth PL6 8DH, United Kingdom. Electronic address: James.Taylor@doctors.org.uk. 4. Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, United Kingdom. Electronic address: Matyas.Czipri@nhs.net. 5. Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, United Kingdom. Electronic address: Nicktalbot@doctors.org.uk. 6. Royal Devon and Exeter Hospital, Barrack Road, Exeter EX2 5DW, United Kingdom. Electronic address: IanSharpe@nhs.net.
Abstract
BACKGROUND: Tibiotalocalcaneal arthrodesis is an important salvage method for patients with complex hindfoot problems. This study reports the elective results of combined subtalar and ankle arthrodesis using one design of retrograde intramedullary compression nail. METHODS: Retrospective review identified 58 patients undergoing 59 tibiotalocalcaneal arthrodesis procedures. Mean follow up was 9.15 (3-36) months with average age 60.7 (22-89) years. A function and subjective patient satisfaction questionnaire was achieved in 89%. RESULTS: 53 patients (93%) achieved union at a mean time of 4.17 months. Four patients (8%) subjectively thought the procedure was of no benefit while 42 (84%) had an excellent or good result. The mean visual analogue scale (VAS) score for preoperative functional pain was 7.46 compared to 1.98 post-operatively (p<0.001). CONCLUSIONS: This device and technique offers an effective treatment of hindfoot pathology giving reliable compression and subsequent fusion with excellent patient satisfaction and pain relief. LEVEL OF EVIDENCE: IV case series.
BACKGROUND: Tibiotalocalcaneal arthrodesis is an important salvage method for patients with complex hindfoot problems. This study reports the elective results of combined subtalar and ankle arthrodesis using one design of retrograde intramedullary compression nail. METHODS: Retrospective review identified 58 patients undergoing 59 tibiotalocalcaneal arthrodesis procedures. Mean follow up was 9.15 (3-36) months with average age 60.7 (22-89) years. A function and subjective patient satisfaction questionnaire was achieved in 89%. RESULTS: 53 patients (93%) achieved union at a mean time of 4.17 months. Four patients (8%) subjectively thought the procedure was of no benefit while 42 (84%) had an excellent or good result. The mean visual analogue scale (VAS) score for preoperative functional pain was 7.46 compared to 1.98 post-operatively (p<0.001). CONCLUSIONS: This device and technique offers an effective treatment of hindfoot pathology giving reliable compression and subsequent fusion with excellent patient satisfaction and pain relief. LEVEL OF EVIDENCE: IV case series.