A Single-Center Comparative Study: Outcome Analysis of Fixation Techniques for Tibiotalocalcaneal Arthrodesis.

Abstract

Introduction Tibiotalocalcaneal arthrodesis (TTCA) is a well-known and accepted surgical technique for end-stage ankle osteoarthritis. The aim of this study is to compare the postoperative clinical and radiological comparison of retrograde intramedullary nailing (RIMN) and plate/cannulated screw (P/cS) fixation methods in patients undergoing TTCA. Methods Patients with end-stage ankle osteoarthritis due to traumatic causes or rheumatic diseases between December 2012 and March 2019 were included in the retrospective study. Patients who underwent isolated tibiotalar or isolated subtalar arthrodesis were not included in the study. Functional scores of patients with bone fusion were evaluated using the American Orthopaedic Foot and Ankle Society (AOFAS) and Short Form-36 (SF-36) quality of life score surveys, administered either in person or by phone. From the radiological point of view, it was evaluated whether the union was achieved with the two-view ankle radiograph. There were 48 patients who underwent ankle arthrodesis in the clinical archive. A total of 31 patients were excluded from the study due to failure to attend follow-up, inability to be reached, or non-compliance with study criteria. The mean age of the patients participating in the study was 44.12 ± 12.95 years, the follow-up time was 40.06 ± 27.31 months, the union time was 5.19 ± 3.17 months, and the AOFAS score was 53.12 ± 13.87. SF-36 scores were evaluated among their own subunits. Results A total of 17 patients were enrolled in the study, of whom 13 were male (76.47%) and 4 were female (23.53%). There was no significant effect of the fixation methods (RIMN or P/cS) selected for TTCA on union times (p>0.05). However, there were significant differences in some parameters of the SF-36 when compared by gender. According to this, the scores of men in physical function (PF), mental health (MH), and general health perception (GHP) were higher than those of women. When AOFAS and SF-36 scores were compared by fixation type, no statistically significant difference was found (p>0.05). Conclusion This study investigated the impact of the fixation method on clinical and radiological outcomes in TTCA. We found that both methods were clinically similar in terms of bone union time and surgical efficacy. However, men had better physical function, mental health, and general health perception after TTCA than women.