Outcome of Tibiotalocalcaneal Fusion with Retrograde Hindfoot Nail.

BACKGROUND

Tibiotalocalcaneal arthrodesis (TTCA) has been an effective surgical treatment for ankle and hindfoot deformity correction and pain relief. This paper presents the results of tibiotalocalcaneal arthrodesis using a hindfoot nail and bone grafting.

MATERIAL AND METHODS

From November 2016 to December 2019, 15 patients underwent tibiotalocalcaneal arthrodesis with a hindfoot nail for treatment of advanced ankle and hindfoot disease. Included cases were 10 instances of end-stage arthritis characterized by severe pain, instability, and challenges in weight-bearing, 4 cases of hindfoot pain with hindfoot fusion non-union (failed arthrodesis fixation), and 1 case of Charcot arthropathy. Unilateral procedures were conducted in all instances, comprising 9 male and 6 female participants. The average age at the surgery date was 56.25 years, ranging from 45 to 63 years. The follow-up duration averaged 16 months, falling within a range of 12 to 18 months.

RESULTS

Successful fusion was observed in all 15 cases. The average AOFAS score, with a maximum of 73 points, increased from an initial mean of 18 points (ranging from 5 to 31) to a mean of 57 points (ranging from 41 to 73), excluding stability and range of motion scores. Patient satisfaction on a scale of 10 points rose from 3 to 7 for both pain and function.

CONCLUSIONS

1. The results of the present study suggest that TTCA using a short, retrograde intramedullary nail is a worldwide accepted technique for achieving fusion with minimal complications. However, long-term follow-up is necessary to provide definitive information about topics such as adjacent degenerative arthritis. 2. Tibiotalocalcaneal fusion with intramedullary nail (Hindfoot Nail) resulted in a higher fusion rate, no/minimal infections, lower pain levels, higher quality of life, and quicker return to work. 3. Retrograde intramedullary nailing offers a safe and reliable salvage option and a very viable alternative to amputation in patients with severe ankle and hindfoot pathologies.