Retrograde intramedullary nail for traumatic tibiotalocalcaneal arthritis / 中国矫形外科杂志

ABSTRACT

[Objective]To evaluate the outcome of tibiotalocalcaneal fusion in traumatic arthritis patients using the locked retrograde intramedullary nail with graft.[Method]Eighteen ankles underwent this procedure.There were 8 males and 10 females,9 with valgus and 2 with talipes equinovarus,all unilateral.The mean age of patients was 57.5 years(ranged,42~69) and the mean time between the procedure from primary trauma was 7.6 years(5~13 years).Bone graft were picked from distal fibula.The nail was inserted through a plantar approach with locking screws placed both proximally and distally.Patients were evaluated by a standardized follow-up examination using the AOFAS and the fusion outcome were observed radiographically.[Result]All patients were available for an average duration of follow-up of 13.5 months(ranged,6~22 months).All wound healed normally.The mean time of full bearing from operation was 13.6 weeks(ranged,9-16 weeks).One patient was found cerebral thrombosis after operation.One patient had moderate pain while walking on even surface,2 mild to moderate pain on uneven surface,1mild pain while standing and 14 relieved from pain.The average AOFAS score improved from 43.5(ranged,40~52) to 69(ranged,56~84) points.Solid fusion was achieved in 13 ankles(72%) after a mean follow-up of 16.8 months(ranged,12~24 months).Partial union was observed in 3 patients(17%) and non-union in 2 patients(11%).[Conclusion]Locked retrograde intramedullary nail fusion with bone graft is effective for traumatic tibiotalocalcaneal arthritis.