Alexander Bradley K, Arguello Alexandra M, Shah Ashish B
University of Alabama at Birmingham, Division of Orthopaedics, 1201 11th Ave S #200, Birmingham, AL, 35205, USA.
J Clin Orthop Trauma. 2020 May-Jun;11(3):482-486. doi: 10.1016/j.jcot.2020.03.012. Epub 2020 Mar 21.
Tibiotalocalcaneal (TTC) arthrodesis is a hindfoot fusion that can treat numerous conditions including osteoarthritis, Charcot arthropathy, avascular necrosis of the talus, and severe deformity. The goal of fusion is to create solid union across the joint while correcting deformity, leaving a shoeable plantigrade foot. Multiple biomechanical studies have demonstrated similar performance when comparing the properties of plate and nail constructs for TTC arthrodesis. Plate fixation and retrograde intramedullary nailing (IMN) are successful in achieving TTC fusion and favorable postoperative outcomes. Despite generally favorable outcomes, TTC arthrodesis carries the risk of complications including nonunion, infection, hardware failure, and revision surgery. We present a case of an individual who presented with a complete break of the IMN after TTC arthrodesis. We also describe the technique used for extraction of the broken nail.
胫距跟（TTC）关节融合术是一种后足融合手术，可治疗多种病症，包括骨关节炎、夏科氏关节病、距骨缺血性坏死和严重畸形。融合的目标是在矫正畸形的同时在关节处实现牢固愈合，使足部能够穿着鞋子并保持足底着地。多项生物力学研究表明，在比较用于TTC关节融合术的钢板和髓内钉结构的特性时，它们具有相似的性能。钢板固定和逆行髓内钉固定（IMN）在实现TTC融合和取得良好术后效果方面是成功的。尽管总体效果良好，但TTC关节融合术仍有并发症风险，包括骨不连、感染、内固定失败和翻修手术。我们报告一例TTC关节融合术后髓内钉完全断裂的病例。我们还描述了取出断裂髓内钉所采用的技术。
