Tibiotalocalcaneal Arthrodesis in Severe Hindfoot Deformities

Martínez-de-Albornoz, Pilar; Monteagudo, Manuel

doi:10.1016/j.fcl.2022.08.008

Cited by 5 publications

(1 citation statement)

References 73 publications

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“…The overall union rate of TCA was 83.6% and is similar to rates reported for tibiotalocalcaneal arthrodesis (TTCA). 16 The majority of patients underwent EF rather than IF. This may represent concerns over the surrounding soft tissue envelope following trauma and the additional advantages in infection.…”

Section: Discussionmentioning

confidence: 99%

The Outcomes of Isolated Tibiocalcaneal Arthrodesis: A Systematic Review

Cossins,

George,

Talia

et al. 2024

Foot & Ankle Orthopaedics

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Background: Tibiocalcaneal arthrodesis (TCA) can be achieved by internal fixation (intramedullary nail or plate), external fixation, or a combination. Evidence for the optimal approach is limited. This systematic review examines the outcomes of these different approaches to guide surgical management. Methods: A MEDLINE and Oxford SOLO search was performed using “tibiocalcaneal,” “ankle,” “fusion OR arthrodesis.” The primary outcome was union. Secondary outcomes included rates of postoperative complications, weightbearing status, rates of revision surgery, and PROMs. We included any studies with follow-up greater than 6 months that contained our primary outcome and at least 1 secondary outcome. Results: The initial search yielded 164 articles, of which 9 studies totaling 53 cases met the criteria. The majority of articles were excluded because they were nonsurgical studies, or were not about isolated TCA but were for tibiotalocalcaneal arthrodesis, more complex reconstructions (eg, Charcot), case reports, and/or did not include the predetermined outcome measures. TCA union rate was 86.2% following external fixation, 82.4% for intramedullary nail fixation, and 83.3% for plate fixation. One patient underwent a hybrid of external and internal fixation, and the outcome was nonunion. The rate of complications following TCA was 69.8%. Conclusion: There is limited evidence on the best operative approach for isolated tibiocalcaneal arthrodesis. Both external and internal fixation methods had comparable union rates. External fixation had frequent complications and a more challenging postoperative protocol. Novel techniques such as 3D-printed cages and talus replacement may become a promising alternative but require further investigation.

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Section: Discussionmentioning

confidence: 99%