Artrodesis tibiotalocalcaneal en el tratamiento del dolor y deformidad del pié..

A. Tavakkolizadeh, a, , M. Klinkea and M.S. Daviesa

aDepartment of Orthopaedics, Guy's & St. Thomas’ Hospitals, London, UK

Abstract

Background Tibiotalocalcaneal arthrodesis is a salvage procedure for patients with severe disease of the ankle and subtalar joints.

Methods We report a series of 26 consecutive patients (26 feet) operated on by a single surgeon in a single centre over a 4 year period with average follow up of 26 months (6–50 months). Average age of the patients was 57 years (28–72 years). Patients had combined ankle and subtalar joint arthrodesis by an intramedullary nail device. Indications for surgery were pain except for the Charcot joints. Only five patients did not have severe deformity pre-operatively. Patients were assessed by AOFAS Ankle-Hindfoot Scale, SF-12, patient satisfaction scores and radiologically.

Results Two patients have died of unrelated causes. Clinically and radiologically 15 have solid union (65%). Six patients have signs of radiological non-union/delayed union but are clinically asymptomatic. Two patients required amputation. One patient has had revision surgery for infected non-union. Most patients are very satisfied with the procedure (79%) and would undergo the procedure again (83%).

Conclusion Majority of cases with combined ankle and subtalar joint arthrosis and severe deformity can be salvaged.