Tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail with a valgus curve

Abstract

Objective To investigate the clinical effects of tibiotalocalcaneal arthrodesis (TTCA) using a retrograde intramedullary nail with a valgus curve. Methods At our department, 22 patients underwent TTCA using a retrograde intramedullary nail with a valgus curve from June 2009 to January 2014 and were available for complete follow-up. They were 12 men and 10 women, aged from 46 to 79 years (average, 62.2 years). There were 3 cases of primary ankle osteoarthritis, 9 ones of traumatic arthritis, one of ankle arthritis secondary to severe talar avascular necrosis, 3 ones of progressive subtalar arthritis following failed ankle replacement, 5 ones of progressive subtalar arthritis following failed ankle arthrodesis, and one of arthritis secondary to equinovarus. The outcome measurements included the American Foot and Ankle Society (AOFAS) ankle-hindfoot scale, EQ-5DTM functional score, radiologic assessment and clinical examination. Results The mean follow-up was 21.3 months (range, from 14 to 38 months). A plantigrade foot and bony union were achieved in all the patients after a mean time of 3.9 months (range, from 2.4 to 6.2 months). Postoperative radiologic results showed a good hindfoot alignment in all the patients. Superficial infection oc-curred in one patient and loosening of the distal screw in another who asked for removal. The mean postop-erative EQ-5DTM functional score and AOFAS ankle-hindfoot score were 69.3 (range, from 20 to 90) and 69.9 (range, from 45 to 85), respectively. Conclusion TTCA using a retrograde curved intramedullary nail may lead to solid fusion and good hindfoot alignment. Key words: Foot deformities; Arthrodesis; Bone nail; Arthritis