Tibiotalocalcaneal Arthrodesis in a Singaporean Hospital

Purpose. To report 18 patients who underwent tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail or cannulated screws. Methods. 10 men and 8 women (19 ankles) aged 36 to 70 (mean, 52) years underwent tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail (n=13) or ca...

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Main Authors: Bryan Yijia Tan, Sean Yung Chuan Ng, Keen Wai Chong, Inderjeet Singh Rikhraj
Format: Article
Language:English
Published: SAGE Publishing 2013-04-01
Series:Journal of Orthopaedic Surgery
Online Access:https://doi.org/10.1177/230949901302100114
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author Bryan Yijia Tan
Sean Yung Chuan Ng
Keen Wai Chong
Inderjeet Singh Rikhraj
author_facet Bryan Yijia Tan
Sean Yung Chuan Ng
Keen Wai Chong
Inderjeet Singh Rikhraj
author_sort Bryan Yijia Tan
collection DOAJ
description Purpose. To report 18 patients who underwent tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail or cannulated screws. Methods. 10 men and 8 women (19 ankles) aged 36 to 70 (mean, 52) years underwent tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail (n=13) or cannulated screws (n=6). Indications for arthrodesis were severe cavovarus deformity secondary to polio or charcot-marie-tooth disease (n=7), severe osteoarthritis in the ankle and subtalar joints (n=6), Charcot joint deformity (n=3), failed fusion procedures (n=2), and foot drop secondary to T12 tumour surgery (n=1). The visual analogue score (VAS) for pain was assessed, as were the American Orthopaedic Foot and Ankle Society (AOFAS) scores (for subjective and objective pain, function, and stability of the ankle), short form 36 (SF-36), and patient expectation and satisfaction scores. Results. The mean follow-up period was 35.6 (range, 11–144) months. 13 of 18 patients returned for assessment of scores. 18 of the 19 ankles achieved fusion after a mean period of 5.9 (range, 3–11) months. The mean VAS scores for pain, AOFAS scores, and SF-36 scores all improved. 11 patients had good-to-excellent satisfaction and expectation scores. Two patients had severe wound infections and underwent implant removal (after bone union), debridement, and intravenous antibiotic therapy. Two other patients had superficial wound infections. One patient with retrograde intramedullary nailing had a pseudoarthrosis and underwent implant removal, redebridement, re-autografting, and cannulated screw fixation. Fusion was achieved subsequently. Conclusion. Tibiotalocalcaneal arthrodesis improved the pain score and quality of life, despite a high risk of complications.
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spelling doaj.art-faba982cc5f84367bac5a3560550abc12022-12-22T00:39:22ZengSAGE PublishingJournal of Orthopaedic Surgery2309-49902013-04-012110.1177/230949901302100114Tibiotalocalcaneal Arthrodesis in a Singaporean HospitalBryan Yijia TanSean Yung Chuan NgKeen Wai ChongInderjeet Singh RikhrajPurpose. To report 18 patients who underwent tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail or cannulated screws. Methods. 10 men and 8 women (19 ankles) aged 36 to 70 (mean, 52) years underwent tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail (n=13) or cannulated screws (n=6). Indications for arthrodesis were severe cavovarus deformity secondary to polio or charcot-marie-tooth disease (n=7), severe osteoarthritis in the ankle and subtalar joints (n=6), Charcot joint deformity (n=3), failed fusion procedures (n=2), and foot drop secondary to T12 tumour surgery (n=1). The visual analogue score (VAS) for pain was assessed, as were the American Orthopaedic Foot and Ankle Society (AOFAS) scores (for subjective and objective pain, function, and stability of the ankle), short form 36 (SF-36), and patient expectation and satisfaction scores. Results. The mean follow-up period was 35.6 (range, 11–144) months. 13 of 18 patients returned for assessment of scores. 18 of the 19 ankles achieved fusion after a mean period of 5.9 (range, 3–11) months. The mean VAS scores for pain, AOFAS scores, and SF-36 scores all improved. 11 patients had good-to-excellent satisfaction and expectation scores. Two patients had severe wound infections and underwent implant removal (after bone union), debridement, and intravenous antibiotic therapy. Two other patients had superficial wound infections. One patient with retrograde intramedullary nailing had a pseudoarthrosis and underwent implant removal, redebridement, re-autografting, and cannulated screw fixation. Fusion was achieved subsequently. Conclusion. Tibiotalocalcaneal arthrodesis improved the pain score and quality of life, despite a high risk of complications.https://doi.org/10.1177/230949901302100114
spellingShingle Bryan Yijia Tan
Sean Yung Chuan Ng
Keen Wai Chong
Inderjeet Singh Rikhraj
Tibiotalocalcaneal Arthrodesis in a Singaporean Hospital
Journal of Orthopaedic Surgery
title Tibiotalocalcaneal Arthrodesis in a Singaporean Hospital
title_full Tibiotalocalcaneal Arthrodesis in a Singaporean Hospital
title_fullStr Tibiotalocalcaneal Arthrodesis in a Singaporean Hospital
title_full_unstemmed Tibiotalocalcaneal Arthrodesis in a Singaporean Hospital
title_short Tibiotalocalcaneal Arthrodesis in a Singaporean Hospital
title_sort tibiotalocalcaneal arthrodesis in a singaporean hospital
url https://doi.org/10.1177/230949901302100114
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