Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
권호 표지
DOI QR코드

DOI QR Code

The Surgical Outcome of Tibiotalocalcaneal Arthrodesis Using a Retrograde Intramedullary Nail

역행성 골수강 내 금속정을 이용한 경-거-종골 유합술의 술 후 결과

  • Lee, Myoung Jin (Department of Orthopaedic Surgery, College of Medicine, Dong-A University) ;
  • Lee, Young Koo (Department of Orthopaedic Surgery, Bucheon Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Dong Ryul (Department of Orthopaedic Surgery, College of Medicine, Dong-A University) ;
  • Yoo, Jung Woo (Department of Orthopaedic Surgery, Bucheon Hospital, Soonchunhyang University College of Medicine)
  • 이명진 (동아대학교 의과대학 정형외과학교실) ;
  • 이영구 (순천향대학교 의과대학 부천병원 정형외과학교실) ;
  • 김동률 (동아대학교 의과대학 정형외과학교실) ;
  • 유정우 (순천향대학교 의과대학 부천병원 정형외과학교실)
  • Received : 2015.07.22
  • Accepted : 2015.11.06
  • Published : 2015.12.15
Download PDF
⟨ Previous Next ⟩

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 (${\geq}5^{\circ}$), 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.

Keywords

References

  1. Pelton K, Hofer JK, Thordarson DB. Tibiotalocalcaneal arthrodesis using a dynamically locked retrograde intramedullary nail. Foot Ankle Int. 2006;27:759-63. https://doi.org/10.1177/107110070602701001
  2. Aaron AD. Ankle fusion: a retrospective review. Orthopedics. 1990;13:1249-54.
  3. Alfahd U, Roth SE, Stephen D, Whyne CM. Biomechanical comparison of intramedullary nail and blade plate fixation for tibiotalocalcaneal arthrodesis. J Orthop Trauma. 2005;19:703-8. https://doi.org/10.1097/01.bot.0000184142.90448.e3
  4. Chiodo CP, Acevedo JI, Sammarco VJ, Parks BG, Boucher HR, Myerson MS, et al. Intramedullary rod fixation compared with blade-plate-and-screw fixation for tibiotalocalcaneal arthrodesis: a biomechanical investigation. J Bone Joint Surg Am. 2003; 85:2425-8. https://doi.org/10.2106/00004623-200312000-00022
  5. Berend ME, Glisson RR, Nunley JA. A biomechanical comparison of intramedullary nail and crossed lag screw fixation for tibiotalocalcaneal arthrodesis. Foot Ankle Int. 1997;18:639-43. https://doi.org/10.1177/107110079701801007
  6. Gerstenfeld LC, Cullinane DM, Barnes GL, Graves DT, Einhorn TA. Fracture healing as a post-natal developmental process: molecular, spatial, and temporal aspects of its regulation. J Cell Biochem. 2003;88:873-84. https://doi.org/10.1002/jcb.10435
  7. Mann RA, Rongstad KM. Arthrodesis of the ankle: a critical analysis. Foot Ankle Int. 1998;19:3-9. https://doi.org/10.1177/107110079801900102
  8. Mann RA. Arthrodesis of the foot and ankle. In: Mann RA, Coughlin MJ, editors. Surgery of the foot and ankle. 7th ed. Philadelphia: Mosby; 1999. p.651-99.
  9. Abidi NA, Gruen GS, Conti SF. Ankle arthrodesis: indications and techniques. J Am Acad Orthop Surg. 2000;8:200-9. https://doi.org/10.5435/00124635-200005000-00007
  10. Charnley J. Compression arthrodesis of the ankle and shoulder. J Bone Joint Surg Br. 1951;33:180-91.
  11. Chou LB, Mann RA, Yaszay B, Graves SC, McPeake WT 3rd, Dreeben SM, et al. Tibiotalocalcaneal arthrodesis. Foot Ankle Int. 2000;21:804-8. https://doi.org/10.1177/107110070002101002
  12. Myerson MS, Alvarez RG, Lam PW. Tibiocalcaneal arthrodesis for the management of severe ankle and hindfoot deformities. Foot Ankle Int. 2000;21:643-50. https://doi.org/10.1177/107110070002100803