• 作者：V. Pellicer-Garcí ; a ; ^{vipegar@hotmail.com} ; I. Martí ; nez-Garrido ; J. Garcí ; a-Rellá ; n ; R. Domingo-Ferná ; ndez ; D. Herrero-Mediavilla ; E. Sá ; nchez-Alepuz
• 关键词：Clavo retr&oacute ; grado ; Artrodesis tibiotalocalc&aacute ; nea ; Escala AOFAS
• 刊名：Revista Espa帽ola de Cirug铆a Ortop茅dica y Traumatolog铆a
• 出版年：2011
• 期刊代码：pca311_18884415
• 类别：med
• 出版时间：March-April 2011
• 卷：55
• 期：2
• 页码：98-104
• 文件大小：712 K

class="h4">Objective

To evaluate the usefulness of tibiotalocalcaneal arthrodesis using a retrograde nail as a rescue technique in patients with deformity and pain in the tibia-astragalus and sub-astragalus joints.

class="h4">Material and method

A retrospective study of 15 consecutive cases (9 men, 5 women), with a mean age of 46 years, in whom a tibiotalocalcaneal arthrodesis using a retrograde nail was performed. Other measures had failed in all the patients. An anamnesis, physical and radiographic examination, details of previous treatments were carried out, as well as functional assessment using the American Orthopedic Foot and Ankle Society (AOFAS) scale and the degree of fusion after surgery with x-rays and CT.

class="h4">Results

The most common indication was post-traumatic arthrosis 8 of the 15 cases, followed in frequency by primary arthrosis in 4 cases. Consolidation was achieved in 93%of cases (14 of the 15 patients) in a mean time of approximately 20 weeks and a mean follow up of 20 months. Complications were observed in 73%of patients, with delayed consolidation and pseudoarthrosis being the most important. The mean improvement on the AOFAS scale was 43.8 points, mainly due to the improvement in pain.

class="h4">Conclusion

We agree with that published in the literature in considering this a useful rescue technique in patients where previous surgery has failed, and as a procedure of choice in patients with inflammatory arthritic disease. However, it is a demanding technique, with a high percentage of complications, and requires careful selection of the cases and a detailed dialogue on the expectations of the patients.