Tibiotalocalcaneal arthrodesis through retrograde nailing for the treatment of juxtaarticular distal tibia aseptic non-unions: A retrospective study at a minimum follow-up of 4 years

Injury. 2020 Jun;51(6):1377-1381. doi: 10.1016/j.injury.2020.03.039. Epub 2020 Apr 18.

Abstract

Introduction: The purpose of this study is to determine the efficacy of tibiotalocalcaneal arthrodesis by reamed intramedullary nail in the management of the distal tibia non-unions, associated with end-stage osteoarthritis of ankle and subtalar joints.

Materials and methods: 8 patients with radiographical and clinical diagnosis of non-union of the distal tibia have been treated with tibiotalocalcaneal arthrodesis by intramedullary retrograde nail and were retrospectively evaluated. Patients were radiographically and clinically evaluated preoperatively and at final follow-up regarding: satisfaction, AOFAS, VAS. Surgical technique is described.

Results: Mean follow-up was 69.2 ± 23.2 months (range 48-108). In terms of subjective outcome, patients reported a highly satisfying result. All patients returned to daily activities, with an average time of 24.7 ± 8.7 weeks. 6 patients could return to their previous work activity, with an average time of 23.6 ± 6.3 weeks.

Conclusions: The procedure showed good results at final follow up. Consolidation was achieved in all the treated cases. Considering AOFAS and VAS scores at final follow-up, there was an evident improvement of the conditions of the patients.

Keywords: Distal tibia; Juxta-articular; Nonunion; Osteoarthritis; Retrograde nail.

MeSH terms

  • Adult
  • Aged
  • Ankle Joint / surgery*
  • Arthrodesis / adverse effects*
  • Arthrodesis / instrumentation
  • Bone Nails
  • Calcaneus / surgery
  • Female
  • Follow-Up Studies
  • Foot Diseases / complications
  • Foot Diseases / surgery*
  • Fracture Fixation, Intramedullary / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Osteoarthritis / complications
  • Osteoarthritis / surgery*
  • Radiography
  • Retrospective Studies
  • Subtalar Joint / surgery*
  • Talus / surgery
  • Tibia / surgery