Adolfo Perez-Aznar1, Blanca Gonzalez-Navarro1, Laiz L Bello-Tejeda1, Carolina Alonso-Montero2, Alejandro Lizaur-Utrilla3,4, Fernando A Lopez-Prats2. 1. Ankle and Foot Unit, Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax, s/n. 03600, Elda, Alicante, Spain. 2. Department of Traumatology and Orthopaedics, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain. 3. Ankle and Foot Unit, Department of Orthopaedic Surgery, Elda University Hospital, Ctra Elda-Sax, s/n. 03600, Elda, Alicante, Spain. lizaur1@telefonica.net. 4. Department of Traumatology and Orthopaedics, Faculty of Medicine, Miguel Hernandez University, Elche, Alicante, Spain. lizaur1@telefonica.net.
Abstract
PURPOSE: To evaluate prospectively the functional outcomes of tibiotalocalcaneal (TTC) arthrodesis with a contemporary retrograde intramedullary nail after a minimum follow-up of five years. METHODS: Sixty-one patients with a mean age of 51.3 (range, 18-79) years were included in the study. Functional outcome was assessed using the American Orthopaedic Foot and Ankle Society Ankle Hindfoot score (AOFAS), Short-Form 12-item Health Survey (SF12), and visual analog scales (VAS) for both pain and patient satisfaction. Radiographic evaluation was also assessed. RESULTS: The mean post-operative follow-up was 6.8 (range, 5-8) years. Mean AOFAS and SF12 scores significantly improved at the final follow-up (p < 0.001), and the mean VAS for pain significantly decreased (p < 0.001). At the final follow-up, only five (8.2%) patients gave an AOFAS score of less than 50, 52 (85.2%) were satisfied with their surgery, and 32 (52.4%) returned to their employment. There were two tibiotalar joint nonunions that required re-operations, and another patient required re-operation for screw removal. There was no deep infection. CONCLUSIONS: The retrograde intramedullary nail provided a stable TTC arthrodesis with a high union rate, acceptable functional outcomes, and a low severe complication rate. This procedure appears to offer a reliable salvage option for TTC arthrodesis in patients with severe ankle and hindfoot degeneration.
PURPOSE: To evaluate prospectively the functional outcomes of tibiotalocalcaneal (TTC) arthrodesis with a contemporary retrograde intramedullary nail after a minimum follow-up of five years. METHODS: Sixty-one patients with a mean age of 51.3 (range, 18-79) years were included in the study. Functional outcome was assessed using the American Orthopaedic Foot and Ankle Society Ankle Hindfoot score (AOFAS), Short-Form 12-item Health Survey (SF12), and visual analog scales (VAS) for both pain and patient satisfaction. Radiographic evaluation was also assessed. RESULTS: The mean post-operative follow-up was 6.8 (range, 5-8) years. Mean AOFAS and SF12 scores significantly improved at the final follow-up (p < 0.001), and the mean VAS for pain significantly decreased (p < 0.001). At the final follow-up, only five (8.2%) patients gave an AOFAS score of less than 50, 52 (85.2%) were satisfied with their surgery, and 32 (52.4%) returned to their employment. There were two tibiotalar joint nonunions that required re-operations, and another patient required re-operation for screw removal. There was no deep infection. CONCLUSIONS: The retrograde intramedullary nail provided a stable TTC arthrodesis with a high union rate, acceptable functional outcomes, and a low severe complication rate. This procedure appears to offer a reliable salvage option for TTC arthrodesis in patients with severe ankle and hindfoot degeneration.
Authors: Luca Dalla Paola; Antonio Volpe; Davide Varotto; Andrea Postorino; Enrico Brocco; Antonella Senesi; Maurizio Merico; Daniele De Vido; Roberto Da Ros; Roberta Assaloni Journal: Foot Ankle Int Date: 2007-09 Impact factor: 2.827
Authors: A Carranza-Bencano; S Tejero; G Del Castillo-Blanco; J J Fernández-Torres; A Alegrete-Parra Journal: Foot Ankle Int Date: 2013-12-11 Impact factor: 2.827