Ankle Arthrodesis with a Retrograde Femoral Nail for Charcot Ankle Arthropathy

Pinzur, Michael S.; Noonan, Timothy M

doi:10.1177/107110070502600709

Cited by 108 publications

(61 citation statements)

References 13 publications

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“…Our overall union rate of 79.4% is comparable to the outcomes in that systematic review and the published data we reviewed for the present study (2–5,7–9,13,23–37) (Table 4). The published data review presented in Table 4 identified 342 diabetic patients with CN who underwent TTCA.…”

Section: Discussionsupporting

confidence: 86%

“…The contraindications specific to using the intramedullary nail (IMN) technique include active infection, severe angular deformity of the distal tibia, severe osteoporosis, and an intact subtalar joint (1). TTCA has been used as a method for limb salvage to avoid major amputation, in particular, in diabetic patients with lower extremity complications (2–9). This technique has gained popularity over the years, in part owing to the increased rigidity of the construct compared with that of other fixation techniques.…”

mentioning

confidence: 99%

“…Multiple studies have shown biomechanically superior bending and torsional properties with the IMN compared with lag screws (10–12). Successful limb salvage has been reported using retrograde intramedullary nailing; however, the procedure can be fraught with many complications, such as nonunion rates ranging from 0% to 71% (2,3,5,7–9,13,14). A preliminary study of 40 patients from our institution demonstrated significant improvement in the American Orthopaedic Foot and Ankle Society scores in patients with and without diabetes mellitus (DM), despite high complication rates in both groups (14).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Tibiotalocalcaneal Arthrodesis Using Retrograde Intramedullary Nail Fixation: Comparison of Patients With and Without Diabetes Mellitus

Wukich

Mallory

Suder

et al. 2015

The Journal of Foot and Ankle Surgery

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Retrograde intramedullary nailing for tibiotalocalcaneal arthrodesis is a salvage procedure reserved for severe cases of deformity. The aim of the present study was to compare the outcomes of this technique in patients with and without diabetes mellitus (DM). A total of 61 patients with and 56 without DM underwent retrograde intramedullary nailing and had a minimum follow-up period of 12 months. The overall incidence of complication was 45.2%; however, the overall incidence of complications between those with and without DM was not significantly different (odds ratio [OR] 0.79, 95% confidence interval [CI] 0.38 to 1.65, p = .54). Patients with DM had a significantly greater rate of superficial infections (OR 8.3, 95% CI 1.01 to 68.67, p = .03). However, no difference was seen in the rate of deep infection (OR 0.90, 95% CI 0.34 to 2.46, p = .83) or noninfectious complications (OR 0.50, 95% CI 0.23 to 1.13, p = .09). Successful limb salvage was achieved for 96.8% of the patients with DM and 94.7% of those without DM (p = .66). A femoral head allograft was used in 32 (27.4%) of 117 patients to substitute for an osseous void. Of the 32 patients who required a femoral head allograft, 21 (67.7%) experienced a complication compared with 32 (37.6%) of 85 patients who did not require a femoral head allograft (OR 3.16, 95% CI 1.35 to 7.41, p = .008). The incidence of patient satisfaction was 80% for patients with DM and 72% for those without DM (p = .36). Despite a high incidence of complications, limb salvage was accomplished in approximately 95% of patients with complicated deformities. Four patients (6.56%) with DM experienced a tibia fracture; therefore, we now routinely use a 300-mm-long nail for this reconstruction.

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Section: Discussionsupporting

confidence: 86%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Tibiotalocalcaneal Arthrodesis Using Retrograde Intramedullary Nail Fixation: Comparison of Patients With and Without Diabetes Mellitus

Wukich

Mallory

Suder

et al. 2015

The Journal of Foot and Ankle Surgery

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“…While many authors [36][37][38][39][40][41][42] have reported complications in treatment of fractures in diabetic patients, only a small number of studies have reported results in the treatment of non-union in diabetic patients or in non-diabetic patients [43]. The size of our diabetic sample treated with MSCs comprising 86 patients is relatively small, which is a weakness of this study.…”

Section: Discussionmentioning

confidence: 63%

Percutaneous injection of bone marrow mesenchymal stem cells for ankle non-unions decreases complications in patients with diabetes

Hernigou

Guissou

Homma

et al. 2015

International Orthopaedics (SICOT)

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“…[19] Daha uzun bir çivi ile artrodez yapılırsa stres odaklanması ortadan kaldı-rılarak kaynama elde edilir. [20] Bir hastamızda ameliyat sonrası ikinci ayda çivi proksimalinde kırık ortaya çıktı. Bu hastadaki çiviyi daha uzun bir çiviyle değiştirerek hem artrodez sahasında hemde proksimaldeki kırıkta kaynama elde edildi.…”

Section: Discussionunclassified

Ankle and Subtalar Joint Arthrodesis with Retrograde Intramedullary Nail

Kurtulmuş¹,

Kibar²,

Sağlam³

et al. 2013

J Kartal TR

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ÖzetAmaç: Ayak bileği artrodezi ayak bileğinin belirli patolojik koşullarının tedavisinde yerleşik bir tedavi seçeneğidir. Endikasyonlar yıllar içinde genişlese de temel prensipler aynı kalmıştır; deformitenin düzeltilmesi, ağrının hafifletilmesi ve stabilitenin sağlanmasıdır. Biz bu çalışmada retrograd intramedüller çivi ile tibiotalokalkaneal artrodez yaptığımız hastalardaki sonuçları değerlendirdik. Gereç ve Yöntem:Ocak 2007-Ocak 2012 tarihleri arasında retrograd intramedüller çivi ile tibiotalokalkaneal artrodez uygulanan yedi hasta (2 erkek, 5 kadın; ort. yaş 56.5±7.7; dağılım 13-67 yıl) geriye dönük olarak değerlendirildi. Hastaların etiyolojisine baktığımızda travma sonrası artroz %42.8 (n=3), diyabetik nöroartropati %14.2 (n=1), düşük ayak %14.2 (n=1), poliomiyelit zemininde bimalleolar kırık sonrası artroz %14.2 (n=1), doğuştan duyarsızlık sendromu zemininde kalkaneus apofiz avülsiyonuna sekonder Charcot eklemi %14.2 (n=1), pes ekino varus sekeli %14.2 (n=1) hastada mevcuttu. Bütün hastalarda titanyum retrograd intramedüller çivi kullanıldı. Bulgular: Bütün hastalarda ortalama 13±4.24 (dağılım 10-16) haftada kaynama elde edildi. Yara komplikasyonu, enfeksiyon, implant yetmezliği görülmedi. Ameliyat öncesi 18±2.1 (dağılım, 4-32) olan AOFAS skoru ameliyat sonrası 58±1.8 (dağılım, 46-72) olarak belirlendi. Sonuç:İntramedüller çivi diğer implantlarla karşılaştırıldı-ğında yüksek eğilme direnci, artmış rotasyonel stabilite, dinamik kompresyon kapasitesi sağlar. Bu çalışmada nispeten hasta sayısı az olmasına rağmen; retrograd intramedüller çiviyle ayak bileği artrodezi, yüksek kaynama oranlarıyla, iyi fonksiyonel sonuç elde etmek için güvenilir bir yöntemdir.

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Ankle Arthrodesis with a Retrograde Femoral Nail for Charcot Ankle Arthropathy

Abstract: The use of a retrograde femoral nail for ankle arthrodesis in patients with Charcot arthropathy appears to decrease the risk of stress fracture compared with shorter nails without increasing the risk of other complications.

Cited by 108 publications

References 13 publications

Tibiotalocalcaneal Arthrodesis Using Retrograde Intramedullary Nail Fixation: Comparison of Patients With and Without Diabetes Mellitus

Tibiotalocalcaneal Arthrodesis Using Retrograde Intramedullary Nail Fixation: Comparison of Patients With and Without Diabetes Mellitus

Percutaneous injection of bone marrow mesenchymal stem cells for ankle non-unions decreases complications in patients with diabetes

Ankle and Subtalar Joint Arthrodesis with Retrograde Intramedullary Nail

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