Lee BH, et al. - Researchers, herein, describe the experience with tibiotalocalcaneal arthrodesis (TTCA) using an intramedullary nail in a series of 20 patients. As per their observations, TTCA performed with an intramedullary nail appeared to afford a reliable and safe alternative for patients with severe ankle and hindfoot pathologic entities, including those with diabetes mellitus.

Methods

• This study included 20 patients who underwent TTCA using an intramedullary nail.
• Researchers analyzed the patient experiences and outcomes.

Results

• Overall, this study comprised 20 patients, of those, 7 (35%) had diabetes mellitus.
• Their mean age was 61.1 (range 39 to 78) years, and 13 (mean 28, range 13 to 49) months was the minimum follow-up period.
• Diabetic Charcot arthropathy, hindfoot osteoarthritis, and severe equinovarus deformity were the surgical indications in 7 (35%), 10 (50%), and 3 (15%), respectively.
• Use of a calcaneal spiral blade in 2 patients (10%) was reported.
• Researchers observed significant improvements (p < .05) in 5 of 8 Short-Form 36-item Health Survey components, the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot scale (p < .001), and visual analog scale for pain (p < .001).
• The reported mean length of the hospital stay was 6.7 (range 1 to 27) days.
• Postoperative improved activity was attained in 76.9% of the 20 patients.
• Data also reported that after a mean of 7.89 (range 3 to 24) months, 81.8% were able to resume their preoperative work.
• Overall, favorable outcomes were reported by 19 patients (95%).
• The most common complications (35%) included superficial wound infection (n = 4; 20%) and deep wound infection (n = 3; 15%), with 1 case (5%) culminating in a below-the-knee amputation.
• Findings demonstrated that radiographic union was achieved in 16 of the tibiotalar joints (80%), 16 subtalar joints (80%), and 4 tibiocalcaneal fusions (20%).
• In addition, the incidence of wound complications and fusion in a subgroup analysis of 7 patients with diabetes mellitus (35%), was comparable to that of the primary cohort.