Long-term Results of Ankle Arthrodesis Using an Intramedullary Nail with Fins in Patients with Rheumatoid Arthritis Hindfoot Deformity

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

“…Mid-and long-term outcomes of retrograde intramedullary ankle nail fixation with fins for patients with RA have been reported. [14][15][16] The mid-term result after intramedullary ankle nail fixation for 51 highly destructive ankle joint cases showed a mean follow-up duration of 71.6 +-51.1 months and a mean postoperative JSSF score of 65.3 +-14.9 (range, 30-84). However, nonunion of the subtalar joint was detected in 43.3% of cases (23 joints), and an absence of subtalar curettage and earlier postoperative weight-bearing were significantly associated with subtalar nonunion on multivariate analysis of risk factors for nonunion.…”

“…For 30 RA cases that underwent ankle arthrodesis using this system, the long-term results were satisfactory because they showed that a high JOA foot score was maintained (64.3 points), even after an average postoperative period of 10.7 years. 16 We used a finned intramedullary retrograde ankle joint nail (unlocking nail system) in these two cases for two reasons. First, this system is easier for surgical procedures than a locking nail system because inserting distal screws is not required.…”

“…When ankles are deformed by RA, both the talocrural and subtalar joints are damaged, and ankle arthrodesis using a retrograde intramedullary ankle nail is the surgical procedure of choice. [11][12][13][14][15][16] Here, we present two cases of patients with RA who presented with highly destructive changes in the ankle joint. We performed retrograde intramedullary nail fixation surgery in both patients, which resulted in good functional outcomes.…”

Ankle Arthrodesis

“…Union rates of open ankle arthrodesis with internal fixation like the tripod screw technique have been reported in the 80% to 100% range. [31][32][33] Intramedullary nail tibiotalocalcaneal arthrodesis has similar reported fusion rates of 89% to 100% fusion at the ankle and slightly less success with concomitant subtalar fusion. 34,35 Delayed union (defined as no evidence of radiographic healing after 3 months) is treated with continued below-the-knee casting, non-weight bearing, and an external bone stimulator.…”

Die Arthrodese des oberen Sprunggelenks

“…Die sehr weit distal platzierten Verriegelungsmöglichkeiten bieten eine sichere Verankerung im Talus oder Kalkaneus und können mit einer Spongiosaanlagerung (Dübeltechnik) kombiniert werden. Hierbei bieten solche Nägel einen Vorteil, die durch eine vorgegebene Kurvatur eine physiologische Valguseinstellung des Rückfußes ermöglichen und die Problematik des korrekten Ferseneintritts des Nagels günstiger adressieren (10).…”