The Surgical Outcome of Tibiotalocalcaneal Arthrodesis Using a Retrograde Intramedullary Nail / 대한족부족관절학회지

ABSTRACT

PURPOSE: Tibiotalocalcaneal arthrodesis has been used as a treatment option for severe deformity including Charcot arthropathy, avascular necrosis of the talus, and severe osteoarthritis of the ankle and subtalar joint. The purpose of this study was to evaluate the result of the surgical outcome of tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail. MATERIALS AND METHODS: Tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail was performed by one surgeon in 36 cases. Clinical and radiological finding was evaluated using assessment of fusion time, 5th metatarsal-tibial angle, possibility of postoperative complication, visual analogue scale for pain and American Orthopaedic Foot and Ankle Society (AOFAS) score. RESULTS: Union was achieved in 33 cases at an average of 23 weeks (11~29 weeks). There were 3 cases of nonunion and 1 case of reoperation. Nail-tibial angle tended to be larger in nonunion cases. AOFAS score showed significantly poor outcome at malalignment (> or =5degrees), negative value of 5th metatarsal-tibial angle. CONCLUSION: Tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail is considered a useful treatment option for severe destruction and deformity involving ankle and subtalar joint.