Comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a mid-term retrospective study
Abstract Background Tibiotalocalcaneal (TTC) arthrodesis with a retrograde intramedullary nail for severe tibiotalar and talocalcaneal arthritis has a high fusion rate; however, no studies have focused on how to handle the fibula intraoperatively to achieve better results. This study aimed to compar...
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-07025-1 |
| _version_ | 1797578613563850752 |
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| author | Wenbao He Haichao Zhou Zhendong Li Youguang Zhao Jiang Xia Yongqi Li Cheng Chen Hui Huang Yi Zhang Bing Li Yunfeng Yang |
| author_facet | Wenbao He Haichao Zhou Zhendong Li Youguang Zhao Jiang Xia Yongqi Li Cheng Chen Hui Huang Yi Zhang Bing Li Yunfeng Yang |
| author_sort | Wenbao He |
| collection | DOAJ |
| description | Abstract Background Tibiotalocalcaneal (TTC) arthrodesis with a retrograde intramedullary nail for severe tibiotalar and talocalcaneal arthritis has a high fusion rate; however, no studies have focused on how to handle the fibula intraoperatively to achieve better results. This study aimed to compare the efficacies of various fibular procedures. Methods We retrospectively reviewed the cases of severe tibiotalar and talocalcaneal arthritis in adults treated with TTC arthrodesis using a retrograde intramedullary nail between January 2012 and July 2017. The patients were divided into three groups according to different fibular procedures: Fibular osteotomy (FO), fibular strut (FS), and fibular preservation (FP). Functional outcomes and pain were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and visual analog scales (VAS), respectively. The operation time, fusion time, radiographic evaluation, and complications were also recorded. Results Fifty-eight patients with an average age of 53.2 (range, 32–69) years were enrolled in the final analysis. The numbers of patients enrolled in the three groups were 21, 19, and 18 in the FO, FS, and FP groups, respectively. The mean postoperative follow-up time was 66.0 (range, 60–78) months. All groups showed a high fusion rate (90.5% for FO, 94.7% for FS, and 94.4% for FP) and significant improvement in AOFAS ankle and hindfoot scores and VAS scores at the latest follow-up. There were no significant differences in these parameters among the three groups. The mean operation time of FS (131.3 ± 17.1 min) was longer than that of FO (119.3 ± 11.7 min) and FS (112.2 ± 12.6 min), but the fusion time was shorter (15.1 ± 2.8 weeks for FS, 17.2 ± 1.9 weeks for FO, and 16.8 ± 1.9 weeks for FP). Statistically significant differences were observed in these parameters. Conclusions TTC arthrodesis using a retrograde intramedullary nail is an effective procedure with a high rate of fusion to treat severe tibiotalar and talocalcaneal arthritis in adults; however, FSs can shorten fusion time when compared with FO and FP. Level of clinical evidence Level 3. |
| first_indexed | 2024-03-10T22:25:17Z |
| format | Article |
| id | doaj.art-99b6b34ce9624a86b1b0b6db66b14af4 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-10T22:25:17Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-99b6b34ce9624a86b1b0b6db66b14af42023-11-19T12:08:36ZengBMCBMC Musculoskeletal Disorders1471-24742023-11-012411810.1186/s12891-023-07025-1Comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a mid-term retrospective studyWenbao He0Haichao Zhou1Zhendong Li2Youguang Zhao3Jiang Xia4Yongqi Li5Cheng Chen6Hui Huang7Yi Zhang8Bing Li9Yunfeng Yang10Department of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityDepartment of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityAbstract Background Tibiotalocalcaneal (TTC) arthrodesis with a retrograde intramedullary nail for severe tibiotalar and talocalcaneal arthritis has a high fusion rate; however, no studies have focused on how to handle the fibula intraoperatively to achieve better results. This study aimed to compare the efficacies of various fibular procedures. Methods We retrospectively reviewed the cases of severe tibiotalar and talocalcaneal arthritis in adults treated with TTC arthrodesis using a retrograde intramedullary nail between January 2012 and July 2017. The patients were divided into three groups according to different fibular procedures: Fibular osteotomy (FO), fibular strut (FS), and fibular preservation (FP). Functional outcomes and pain were assessed using the American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot score and visual analog scales (VAS), respectively. The operation time, fusion time, radiographic evaluation, and complications were also recorded. Results Fifty-eight patients with an average age of 53.2 (range, 32–69) years were enrolled in the final analysis. The numbers of patients enrolled in the three groups were 21, 19, and 18 in the FO, FS, and FP groups, respectively. The mean postoperative follow-up time was 66.0 (range, 60–78) months. All groups showed a high fusion rate (90.5% for FO, 94.7% for FS, and 94.4% for FP) and significant improvement in AOFAS ankle and hindfoot scores and VAS scores at the latest follow-up. There were no significant differences in these parameters among the three groups. The mean operation time of FS (131.3 ± 17.1 min) was longer than that of FO (119.3 ± 11.7 min) and FS (112.2 ± 12.6 min), but the fusion time was shorter (15.1 ± 2.8 weeks for FS, 17.2 ± 1.9 weeks for FO, and 16.8 ± 1.9 weeks for FP). Statistically significant differences were observed in these parameters. Conclusions TTC arthrodesis using a retrograde intramedullary nail is an effective procedure with a high rate of fusion to treat severe tibiotalar and talocalcaneal arthritis in adults; however, FSs can shorten fusion time when compared with FO and FP. Level of clinical evidence Level 3.https://doi.org/10.1186/s12891-023-07025-1Orthopedic procedureOsteoarthritisSurgical techniqueTalocalcaneal jointTibiotalar joint |
| spellingShingle | Wenbao He Haichao Zhou Zhendong Li Youguang Zhao Jiang Xia Yongqi Li Cheng Chen Hui Huang Yi Zhang Bing Li Yunfeng Yang Comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a mid-term retrospective study BMC Musculoskeletal Disorders Orthopedic procedure Osteoarthritis Surgical technique Talocalcaneal joint Tibiotalar joint |
| title | Comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a mid-term retrospective study |
| title_full | Comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a mid-term retrospective study |
| title_fullStr | Comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a mid-term retrospective study |
| title_full_unstemmed | Comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a mid-term retrospective study |
| title_short | Comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail: a mid-term retrospective study |
| title_sort | comparison of different fibula procedures in tibiotalocalcaneal arthrodesis with a retrograde intramedullary nail a mid term retrospective study |
| topic | Orthopedic procedure Osteoarthritis Surgical technique Talocalcaneal joint Tibiotalar joint |
| url | https://doi.org/10.1186/s12891-023-07025-1 |
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