Transportal Tibiotalocalcaneal Nail Ankle Arthrodesis: A Systematic Review of Initial Series

Lameire, Darius L.; Khalik, Hassaan Abdel; Balso, Christopher Del; Daniels, Timothy R.; Halai, Mansur

doi:10.1177/24730114231156422

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…The authors highlighted that if arthroscopic preparation is undertaken, accessory portals may be required to ensure adequate joint preparation. Other studies have found high fusion rates with minimally invasive 22 and arthroscopic 23,24 hindfoot joint preparation for TTC nailing, suggesting these approaches are an alternative when open joint preparation is less favorable.…”

Section: Discussionmentioning

confidence: 99%

Reaming for Tibiotalocalcaneal (TTC) Nailing Removes Only 10% of the Ankle and Subtalar Joints

Baker,

Schroeder,

Kimbler

et al. 2024

Journal of Orthopaedic Trauma

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OBJECTIVES: Tibiotalocalcaneal (TTC) nailing in the setting of acute ankle trauma has become increasingly popular. No consensus exists as to whether formal joint preparation is necessary, although there is some concern that residual motion at unprepared joints may lead to implant loosening and/or breakage. The objective of this study was to quantify the proportion of tibiotalar and subtalar articular surface destruction that occurs during reaming for TTC nail fixation. METHODS: Twelve cadaver lower extremities were procured. The specimens were pinned into neutral ankle and hindfoot alignment. A guide wire was inserted under fluoroscopy, followed by a 12 millimeter opening reamer. The specimens were then dissected, exposing the tibial plafond, talar dome, posterior facet of the talus, and posterior facet of the calcaneus. Images of each joint were obtained and ImageJ software was used to calculate the total joint surface area and the area of articular destruction. RESULTS: The mean proportion of articular cartilage destruction was 9.3%, 10.3%, 8.9%, and 10.3% for the tibial plafond, talar dome, posterior facets of the talus and calcaneus, respectively. No joint destruction was observed in the middle facets of the subtalar joint. CONCLUSIONS: Reaming for TTC nail placement violates approximately 10% of each articular surface of the tibiotalar and subtalar joints. Retention of 90% of the articular surface may allow for residual motion at the joints, and therefore, potentially substantial stress on the implant. Formal joint preparation for the purposes of achieving fusion during TTC nail placement may be beneficial to prevent implant loosening or breakage.

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Section: Discussionmentioning

confidence: 99%

Reaming for Tibiotalocalcaneal (TTC) Nailing Removes Only 10% of the Ankle and Subtalar Joints

Baker,

Schroeder,

Kimbler

et al. 2024

Journal of Orthopaedic Trauma

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“…In the literature, there have been few studies on TTCA with arthroscopic-assisted hindfoot nailing, with varying limitations, and a recent review attempted to report general results [26]. After examining the data of 65 patients in five studies, a significant increase in clinical scores was observed, with a major complication rate of 13.8%.…”

Section: Comparisons Of Applicable Implants Inmentioning

confidence: 99%

Tibiotalocalcaneal Ankle Arthrodesis with Posterior Approach Arthroscopic-Assisted Hindfoot Nailing, Early-Mid-Term Clinical, and Radiological Results: A Retrospective Analysis of 25 Patients

Ertan,

Özbek,

Yoğun

et al. 2024

Preprint

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Background: End-stage ankle arthrosis causes severe pain and limited movement. In this case, tibiotalocalcaneal arthrodesis (TTCA) surgery forms the basis for surgical treatment in the appropriate patient group. TTCA with arthroscopy-assisted hindfoot nailing can be used to achieve a high union rate and low complication rate. In this study, we aimed to examine the early- and mid-term results of patients treated with this technique from various perspectives and to evaluate them by comparing them with the current literature. Methods: Data were collected from 25 patients who met the established criteria and underwent TTCA with posterior approach arthroscopic-assisted hindfoot nailing. In addition to the demographic data of the patients, their clinical and pain scores were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) and visual analogue scale (VAS). These scoring data were collected preoperative, postoperative 3rd month, postoperative 12th month, and at the final postoperative follow-up (18–24th months). Additionally, the union time and complication data during the follow-up period were examined. Results: When the AOFAS and VAS scores of the 25 patients were examined, a significant improvement was observed in the preoperative period and early postoperative period comparisons (p < 0.001). No significant change was observed between the comparison of the postoperative 12th month and last postoperative control clinical scores. While the union rate of the patients was observed to be 92%, the average union time was 13.1 ± 3.5 weeks. During follow-up, peri-implant fracture, deep infection, and non-union were observed in one patient each (12%). Conclusion: The early- and mid-term postoperative results of patients treated with TTCA surgery with posterior approach arthroscopic-assisted hindfoot nailing show that this technique may be an option with low complication and high union rates for the appropriate group of patients planned for ankle arthrodesis.

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Minimal Incision Management of Rearfoot & Ankle Trauma

Chauhan,

Modha,

Rushing

2025

Clinics in Podiatric Medicine and Surgery

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Transportal Tibiotalocalcaneal Nail Ankle Arthrodesis: A Systematic Review of Initial Series

Cited by 4 publications

References 30 publications

Reaming for Tibiotalocalcaneal (TTC) Nailing Removes Only 10% of the Ankle and Subtalar Joints

Reaming for Tibiotalocalcaneal (TTC) Nailing Removes Only 10% of the Ankle and Subtalar Joints

Tibiotalocalcaneal Ankle Arthrodesis with Posterior Approach Arthroscopic-Assisted Hindfoot Nailing, Early-Mid-Term Clinical, and Radiological Results: A Retrospective Analysis of 25 Patients

Minimal Incision Management of Rearfoot & Ankle Trauma

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