• 作者：P. Sá ; nchez Gó ; mez ; ^{placidosanchezgomez@yahoo.es} ; J.E. Salinas Gilabert ; F. Lajara Marco ; J.A. Lozano Requena
• 关键词：Artrodesis tibioastragalocalcá ; nea ; Clavo ; Retró ; grado
• 刊名：Revista Espa?ola de Cirug¨ªa Ortop¨¦dica y Traumatolog¨ªa
• 出版年：2010
• 出版时间：January-February 2010
• 年：2010
• 卷：54
• 期：1
• 页码：50-58
• 全文大小：388 K

Introduction

The purpose of this study is to assess the results of patients subjected to a tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail.

Materials and methods

We studied 8 patients of a mean age of 60 years that showed involvement of the tibiotalar and subtalar joints with significant gait alterations and acute pain, secondary to either primary or post-traumatic arthritis or pseudoarthrosis of a previous arthrodesis. There was also one case of a severe deformity secondary to acute stroke. Patients were treated by means of tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail. The AOFAS scale was used to assess functional results before and after surgery.

Results

Mean follow-up was 32 months (range: 7?1). Overall results were highly satisfactory, with a mean score of 88.6 points.

Healing occurred alter a mean 18.3 weeks. The most frequent complications were an instance of mild skin necrosis at the edges of the wound, a plantar ulcer that resolved with conservative treatment and a leg length discrepancy of 2 cm.

Conclusion

Tibiotalocalcaneal arthrodesis with a retrograde nail can be an excellent technique for patients with severe involvement of the tibiotalar and subtalar joints who are unresponsive to conservative treatment. It can also be used as salvage surgery in previously failed arthrodesis procedures.