Outcomes and Complications of Tibiotalocalcaneal Arthrodesis
Category: Ankle Arthritis; Hindfoot Introduction/Purpose: Tibio-talo-calcaneal (TTC) arthrodesis is usually a salvage procedure to address several hindfoot and ankle conditions. Non-union rate after TTC fusion is variably reported 3.4% - 48%. The aims of this study were to describe the outcomes and...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2023-12-01
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| Series: | Foot & Ankle Orthopaedics |
| Online Access: | https://doi.org/10.1177/2473011423S00363 |
| _version_ | 1797375232037617664 |
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| author | Aly M. Fayed MD, MSc Nacime Salomao Barbachan Mansur MD, PhD Natalie Glass PhD Phinit Phisitkul MD John Femino MD |
| author_facet | Aly M. Fayed MD, MSc Nacime Salomao Barbachan Mansur MD, PhD Natalie Glass PhD Phinit Phisitkul MD John Femino MD |
| author_sort | Aly M. Fayed MD, MSc |
| collection | DOAJ |
| description | Category: Ankle Arthritis; Hindfoot Introduction/Purpose: Tibio-talo-calcaneal (TTC) arthrodesis is usually a salvage procedure to address several hindfoot and ankle conditions. Non-union rate after TTC fusion is variably reported 3.4% - 48%. The aims of this study were to describe the outcomes and complications of this procedure and to determine potential risk factors associated with non-union. Methods: In this IRB-approved retrospective cohort study, we used the following codes (28705,28725 and 27870) to search the medical records for all patients who underwent TTC fusion between 2006-2022. All relevant demographic data, surgical indications, surgery details (type of the graft, type of the implant, and surgical approach, associated procedures), post-operative course (complications and union rate) and follow-up duration were extracted. Descriptive statistics were performed, and continuous variables were described using median (interquartile range) and categorical variables were described using frequency (%) and mean (standard deviation, SD). Patients and surgery characteristics were compared between united and non-united cases using Wilcoxon Rank Sum Tests for continuous variables and Chi-squared or exact tests, as appropriate, for categorical variables. Analyses were performed using SAS statistical software version 9.4 (SAS Institute Inc., Cary, NC). Results: Fifty-one patients (53 feet) were included in the study. Long hindfoot fusion nails were used in 51 cases.Ten cases were routinely dynamized 8-10 weeks after surgery. In 24 (45.3%) patients, morselized allograft was combined with infuseTM and reamer irrigation aspiration autograft (RIA). In 20 (37.7%) patients, morselized allograft was combined with infuseTM only. There were 6 non-union cases (11.3%). When comparing patients and surgery characteristics between non-union versus union group, smoking (P = 0.0150) and routine dynamization (P= 0.0297) were higher in the non-union group. No difference in union rates between different types of graft. Frequency of other complications is listed in (Figure 1). Follow up duration was 27.2 months (range 4-108 months). Conclusion: TTC fusion achieves good union rate (88.68%), however it carries a relatively high risk of complications. Routine dynamization of the TTC nail at 8-10 weeks could be a risk factor for non-union. Smoking was also associated with a high non- union rate. |
| first_indexed | 2024-03-08T19:19:17Z |
| format | Article |
| id | doaj.art-42700c2c04af4dbca3f6d664597d51a8 |
| institution | Directory Open Access Journal |
| issn | 2473-0114 |
| language | English |
| last_indexed | 2024-03-08T19:19:17Z |
| publishDate | 2023-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Foot & Ankle Orthopaedics |
| spelling | doaj.art-42700c2c04af4dbca3f6d664597d51a82023-12-26T19:05:13ZengSAGE PublishingFoot & Ankle Orthopaedics2473-01142023-12-01810.1177/2473011423S00363Outcomes and Complications of Tibiotalocalcaneal ArthrodesisAly M. Fayed MD, MScNacime Salomao Barbachan Mansur MD, PhDNatalie Glass PhDPhinit Phisitkul MDJohn Femino MDCategory: Ankle Arthritis; Hindfoot Introduction/Purpose: Tibio-talo-calcaneal (TTC) arthrodesis is usually a salvage procedure to address several hindfoot and ankle conditions. Non-union rate after TTC fusion is variably reported 3.4% - 48%. The aims of this study were to describe the outcomes and complications of this procedure and to determine potential risk factors associated with non-union. Methods: In this IRB-approved retrospective cohort study, we used the following codes (28705,28725 and 27870) to search the medical records for all patients who underwent TTC fusion between 2006-2022. All relevant demographic data, surgical indications, surgery details (type of the graft, type of the implant, and surgical approach, associated procedures), post-operative course (complications and union rate) and follow-up duration were extracted. Descriptive statistics were performed, and continuous variables were described using median (interquartile range) and categorical variables were described using frequency (%) and mean (standard deviation, SD). Patients and surgery characteristics were compared between united and non-united cases using Wilcoxon Rank Sum Tests for continuous variables and Chi-squared or exact tests, as appropriate, for categorical variables. Analyses were performed using SAS statistical software version 9.4 (SAS Institute Inc., Cary, NC). Results: Fifty-one patients (53 feet) were included in the study. Long hindfoot fusion nails were used in 51 cases.Ten cases were routinely dynamized 8-10 weeks after surgery. In 24 (45.3%) patients, morselized allograft was combined with infuseTM and reamer irrigation aspiration autograft (RIA). In 20 (37.7%) patients, morselized allograft was combined with infuseTM only. There were 6 non-union cases (11.3%). When comparing patients and surgery characteristics between non-union versus union group, smoking (P = 0.0150) and routine dynamization (P= 0.0297) were higher in the non-union group. No difference in union rates between different types of graft. Frequency of other complications is listed in (Figure 1). Follow up duration was 27.2 months (range 4-108 months). Conclusion: TTC fusion achieves good union rate (88.68%), however it carries a relatively high risk of complications. Routine dynamization of the TTC nail at 8-10 weeks could be a risk factor for non-union. Smoking was also associated with a high non- union rate.https://doi.org/10.1177/2473011423S00363 |
| spellingShingle | Aly M. Fayed MD, MSc Nacime Salomao Barbachan Mansur MD, PhD Natalie Glass PhD Phinit Phisitkul MD John Femino MD Outcomes and Complications of Tibiotalocalcaneal Arthrodesis Foot & Ankle Orthopaedics |
| title | Outcomes and Complications of Tibiotalocalcaneal Arthrodesis |
| title_full | Outcomes and Complications of Tibiotalocalcaneal Arthrodesis |
| title_fullStr | Outcomes and Complications of Tibiotalocalcaneal Arthrodesis |
| title_full_unstemmed | Outcomes and Complications of Tibiotalocalcaneal Arthrodesis |
| title_short | Outcomes and Complications of Tibiotalocalcaneal Arthrodesis |
| title_sort | outcomes and complications of tibiotalocalcaneal arthrodesis |
| url | https://doi.org/10.1177/2473011423S00363 |
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