Treatment of posttraumatic tibiotalar and talocalcaneal arthritis with tibiotalocalcaneal arthrodesis plus retrograde intramedullary nail / 中华创伤杂志

ABSTRACT

Objective To investigate the clinical outcome of tibiotalocalcaneal arthrodesis plus retrograde intramedullary nail in treatment of severe posttraumatic tibiotalar and talocalcaneal arthritis.Methods A total of 17 cases of severe posttraumatic tibiotalar and subtalar arthritis were treated with tibiotalocalcaneal arthrodesis plus retrograde intramedullary nail between June 2003 and June 2006.Patients were evaluated by a standardized follow-up examination using ankle-hindfoot scale of the American Orthopedic Foot & Ankle Society(OFAS)score. Results Of all,14 cases were followed up postoperatively,with a mean follow-up period of 14.6 months(6-23 months).Bony fusion was achieved in 12 cases (86%)after an average of 11.6 weeks(8-19 weeks)but a delayed union in 2 after 17-19 weeks.Two cases(12%)complained heel pain at the nail entry point at initial stage of operation.The average anklehindfoot score improved from 47 points(43-55 points)preoperatively to 75 points(69-86 points)postoperatively. Conclusion Tibiotalocalcancal arthrodesis plus retrograde intramedullary nailing is proved to be effective in treating severe posttraumatic tibiotalar and talocalcaneal arthritis by marked relief from pain and improvement of life quality.