Ankle arthrodesis using a retrograde intramedullary rod with fins for highly destructive joints in elderly patients with rheumatoid arthritis: A report of two cases

Takahashi, Shun; Kondo, Naoki; Kijima, Yasufumi; Kakutani, Rika; Ishikawa, Hajime; Kawashima, Hiroyuki

doi:10.1002/ccr3.5348

Cited by 1 publication

(1 citation statement)

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“…Instead of using distal transfixation screws, this intramedullary nail had four fins with sharp tips attached to the distal part of a cylindrical nail to stabilize the ankle and subtalar joints. Good clinical outcomes of arthrodesis for rheumatoid arthritis using this nail have been described [ 16 , 17 ]. Severe destructive arthrosis due to rheumatoid arthritis often affects both the ankle joint and subtalar joint.…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of the Articular Surface in the Subtalar Joint by Osteochondral Autologous Transplantation After Failure of Tibiotalocalcaneal Fusion With a Retrograde Nail: A Case Report

Sumii,

Nakasa,

Ikuta

et al. 2023

Cureus

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Tibiotalocalcaneal arthrodesis (TTCA) using the intramedullary nail has been conducted for severe deformity of both ankle and subtalar joints. While good clinical outcomes have been reported for TTCA, its nonunion rate is relatively high. We report a case of a 65-year-old male with nonunion of the tibiotalar joint and destruction of the subtalar joint after TTCA using a retrograde intramedullary nail. For this patient, we conducted a salvage procedure for the subtalar joint along with revision surgery for the tibiotalar joint to achieve bone union. The intramedullary nail was removed and the tibiotalar joint was debrided. Two osteochondral plugs were harvested from the lateral aspect of the talus and transplanted to the subtalar joint. The tibiotalar joint was fixed using screws and staples, with bone grafting. Magnetic resonance imaging (MRI) at six months after surgery showed that the articular surface of the subtalar joint was flushed and the osteochondral plugs were united with the surrounding bone. At one year and three months after surgery, the pain in the tibiotalar and subtalar joints had completely disappeared. Plain radiographs revealed that bone union of the tibiotalar joint and joint space of the subtalar joint was maintained. Japanese Society for Surgery of the Foot (JSSF) hindfoot scale improved from 53 points to 84 points at the final follow-up. Reconstruction of the subtalar joint using osteochondral autologous transplantation is a useful technique for failure cases with nonunion of the tibiotalar and subtalar joints after TTCA.

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Section: Discussionmentioning

confidence: 99%