Comparison of retrograde intramedullary nailing versus locking plating for tibiotalocalcaneal arthrodesis / 中华创伤骨科杂志

ABSTRACT

Objective To compare the curative effects of retrograde intramedullary nailing versus locking plating for tibiotalocalcaneal arthrodesis. Methods A retrospective study was performed of the 47 patients who had undergone tibiotalocalcaneal arthrodesis from January 2012 through January 2017 at De-partment of Orthopaedics, Pu'Ai Hospital. Of them, 28 were treated by retrograde intramedullary nailing and 19 by locking plating. The 2 ways of fixation were compared in terms of bony union rate, bony union time, revision rate, complications, American Orthopaedic Foot and Ankle Society ( AOFAS ) Ankle-Hindfoot Scale and Short Form 36 ( SF-36 ) scores. Results The overall bony union rate was 80.9% ( 38/47 ) for the 47 patients; the bony union rate for the intramedullary nailing group ( 71.4%) was significantly lower than that for the locking plating group ( 94.7%) ( P ＜0.05 ). There were no significant differences between the 2 groups in revision rate due to nonunion [ 17.8% ( 5/28 ) versus 5.2% ( 1/19 ) ] , bony union time ( 5.0 ± 0.9 months versus 5.5 ± 1.1 months ) , AOFAS Ankle-Hindfoot Scale ( 80.6 ± 8.4 points versus 79.5 ± 5.7 points) or SF-36 scores ( 78.9 ± 7.1 points versus 88.9 ± 7.7 points ) ( P ＞ 0.05 ) . The locking plating group had a significantly higher incidence of wound complications ( 47.4%) than the intramedullary nailing group (17.9%) ( P ＜0.05), but there were no significant differences between the 2 groups in symptomatic hardware or nerve irritations. Conclusions Both retrograde intramedullary nailing and locking plating can lead to fine curative effects in tibiotalocalcaneal arthrodesis. Although locking plating may result in a higher union rate than retrograde intramedullary nailing, it may cause a higher rate of wound complications.