Objective: The aim of this study was to evaluate clinical and functional outcomes in diabetic patients undergoing tibiocalcaneal arthrodesis using a retrograde nail.
Methods: A total of 12 diabetic patients [8 men and 4 women; mean age at intervention: 56.8 years (range: 27-76 years)] who underwent tibiocalcaneal arthrodesis by a retrograde nail were enrolled in this study. The indication for surgery was massive talar osteonecrosis in four patients, Charcot arthropathy in another four patients, and various severe ankle/hindfoot derangements in four patients. All surgeries were performed by the same surgeon. All patients were evaluated by their American Orthopedic Foot and Ankle Score (AOFAS) score, and radiographic follow-up was performed.
Results: The mean follow-up time was 59.5 months (range: 27-121 months). Ten patients (83.3%) healed and were able to walk with full weight bearing without crutches. Among them, nine patients (75%) achieved union with solid bone healing. The mean overall improvement in the AOFAS score was 72.5% (preoperatively: 40 points vs postoperatively: 69 points; p<0.001). We observe a complication in 50% of our patients. Minor complications included two cases of dehiscence of the surgical wound, one case of soft tissue irritation owing to hardware protrusion, and one cause of lymphedema. Two patients had deep infection and underwent surgical removal of hardware, debridement, and antibiotic treatment: one healed after the treatment but never recovered full weight bearing and the other one died from other complications. These two deep infections occurred after 23 months of follow-up.
Conclusion: Tibiocalcaneal arthrodesis using retrograde nails is a salvage technique extremely effective in ankle and hindfoot disorders in a diabetic patient. This procedure allows good functional outcomes and pain relief. When correctly indicated, it is a safe procedure with good clinical outcomes and low risk of below-knee amputation.
Level Of Evidence: Level IV, Therapeutic study.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7586767 | PMC |
| http://dx.doi.org/10.5152/j.aott.2020.03.334 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Novel Treatment for a Completely Extruded Talus.
Ochsner J
January 2024
Department of Orthopedics, University of New Mexico School of Medicine, Albuquerque, NM.
Complete talar extrusion is a rare injury that is typically caused by high-energy impact. Treatment for a completely extruded talus is limited and has variable outcomes and complications. Tibiocalcaneal arthrodesis is one of the best treatments for restoring stability and reducing pain in the affected limb.
View Article and Find Full Text PDFGiant cell tumor of the talus: A case report and literature review.
Int J Surg Case Rep
January 2025
Hôpital Régional de Ziguinchor, Senegal.
Introduction And Importance: Giant cell tumor is a benign primary bone tumor of mesenchymal origin that mainly affects the long bones. Involvement of the bones of the foot is rare with an incidence of 1 to 2 %. We report a case of giant cell tumor of the talus in a 36-year-old man.
View Article and Find Full Text PDFCalcaneal Lengthening after Tarsal Bone Fusion for Massive Calcaneus Defect Reconstruction.
Orthop Surg
September 2024
Department of Orthopedics, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Article Synopsis
- Calcaneus defects pose a significant challenge in reconstruction due to limited existing treatment options, which often have shortcomings; the study introduces a novel method combining tarsal bone fusion and gradual calcaneus lengthening for cases with substantial bone loss.
- A retrospective analysis of six patients who underwent this technique showed promising results, with an average calcaneal axial lengthening of 43.8 mm and favorable clinical outcomes measured by the American Orthopedic Foot and Ankle Score (AOFAS).
- The findings indicate that using the Ilizarov technique in conjunction with tarsal bone fusion can effectively restore foot and ankle function even in cases of considerable calcaneal loss.
Correction of progressive collapsing foot deformity classes after isolated arthroscopic subtalar arthrodesis.
Foot Ankle Surg
January 2025
Ramsay Santé Clinique de l'Union, Centre de Chirurgie de la Cheville et du Pied, Saint Jean, France.
Introduction: Subtalar osteoarthritis in the context of flatfoot (recently renamed Progressive Collapsing Foot Deformity (PCFD)) may be treated through subtalar joint (SJ) arthrodesis with anticipated consequences on three-dimensional bony configuration. This study investigates the correction of PCFD-related deformities achieved after Anterolateral Arthroscopic Subtalar Arthrodesis (ALAPSTA).
Methods: In this retrospective study, we evaluated pre- and post-operative (at 6 months) weight bearing computed tomography (WBCT) images of patients diagnosed with PCFD with a degenerated SJ (2 A according to PCFD classification) and/or peritalar subluxation (2D) with or without associated flexible midfoot and/or forefoot deformities (1B, 1 C and 1E) which underwent ALAPSTA as a standalone procedure between 2017 and 2020.
Early Reimplantation of Open Total Extruded Talus: A Case Report.
J Orthop Case Rep
May 2024
Department of Orthopedic surgery, Tata Main Hospital, Jamshedpur, Jharkhand, India.
Introduction: Traumatic open total extrusion of talus without soft-tissue attachment and not associated with surrounding fracture is a very rare injury which requires very high energy impact. In literature, optimal treatment protocols are yet to be established. A few options described in literature are talectomy and tibiocalcaneal arthrodesis or reimplantation of talus which may be immediate or after some interval.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!