Retrograde Intramedullary Nailing for Ankle Arthrodesis

Abstract

This is a retrospective study of retrograde intramedullary rodding for ankle arthrodesis in 19 ankles in 16 patients. The preoperative diagnosis of 16 patients was diabetic neuropathic arthropathy in seven patients, rheumatoid arthritis in three patients, post traumatic arthrosis in three patients, paraplegia with fixed equinovarus of the foot in two patients, and avascular necrosis of the talus in one patient. Retrograde intramedullary rodding for ankle arthrodesis was done as a salvage procedure in each patient. Fourteen of the 19 ankles had radiographic evidence of solid arthrodesis. In the four patients with five ankles with pseudarthrosis, no case was clinically significant. There was one deep infection and one broken rod. Thirteen of the 16 patients are ambulatory, and nine required either an ankle-foot orthosis or shoe modification. The standard method of ankle fusion using crossed cancellous screws is the procedure of choice because it preserves the subtalar joint. Retrograde intramedullary rodding for ankle arthrodesis should be considered for patients with significant posttraumatic arthrosis and bone loss following distal tibial plafond fractures, concomitant subtalar arthrosis, severe osteopenia, such as in patients with rheumatoid arthritis, or neuropathic arthropathy.

Tibio-calcaneo-naviculo-cuboidale arthrodesis: 6 patients followed for 1-8 years

“…If there is deformity, necrosis, sclerosis, osteitis, sequestration, etc., the outcome with standard fusion procedures becomes unfavorable (Moore et al 1995, Janis et al 1996. With chronic osteomyelitis of the talus, the likelihood of healing is minimal (Müller 1978a).…”

Die tibiotalare und tibiotalokalkaneare Marknagelarthrodese

“…bei fortgeschrittenen arthrotischen Veränderungen des oberen und gleichzeitig des unteren Sprunggelenkes, Nekrosen des Talus, Erkrankungen aus dem rheumatischen Formenkreis, Versagen der Sprunggelenksendoprothetik und schweren Rückfußdefor-mitäten durchgeführt. Zur Fixation werden in den letzten Jahren zunehmend intramedulläre Implantate eingesetzt [8,16,18,20,23,28,29]. Verschiedene Autoren berichten über gute klinische Ergebnisse [15,16,18,20,23,28,29].…”

“…Zur Fixation werden in den letzten Jahren zunehmend intramedulläre Implantate eingesetzt [8,16,18,20,23,28,29]. Verschiedene Autoren berichten über gute klinische Ergebnisse [15,16,18,20,23,28,29]. Als wesentliche Vorteile der Marknageltechnik wird neben der möglichen perkutanen Insertionstechnik die stabile Osteosynthese aufgeführt [15,18,21,23,29] [2].…”

CORR Insights®: Hindfoot Arthrodesis with the Blade Plate: Increased Risk of Complications and Nonunion in a Complex Patient Population

“…Complications are common, which may include nonunion (as high as 16%) [12] and repeat operations (as high as 22%) [9]. Nonunion after primary TTC may be influenced by the nail tibial angle [12], or brittle diabetes [1], but may be even higher in revision TTC situations.…”

“…Various studies have been completed, evaluating outcomes after TTC arthrodeses, which results in osseous union in 84% to 94% of patients thus treated [1,4,9,12,14]. Complications are common, which may include nonunion (as high as 16%) [12] and repeat operations (as high as 22%) [9].…”