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DOI: 10.1055/s-0041-1731356
Minimally Invasive Tibiotalocalcaneal Arthrodesis with Blocked Retrograde Intramedullary Nail – Report of Three Cases[*]
Artikel in mehreren Sprachen: português | English Financial Support There was no financial support from public, commercial, or non-profit sources.
Abstract
Ankle osteoarthritis (AOA) is associated with pain and variable functional limitation, demanding clinical treatment and possible surgical indication when conservative measures are ineffective – arthrodesis has been the procedure of choice, because it reduces pain, restores joint alignment and makes the segment stable, preserving gait. The present study reports 3 cases (3 ankles) of male patients between 49 and 63 years old, with secondary AOA, preoperative American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS AHS) of 27 to 39 points, treated by minimally invasive tibiotalocalcaneal arthrodesis using blocked retrograde intramedullary nail. Hospital stay was of 1 day, and the patients were authorized for immediate loading with removable ambulation orthotics, as tolerated. The physical therapy treatment, introduced since hospitalization, was maintained, prioritizing gait training, strength gain, and proprioception. Clinical and radiographic follow-up was performed at weeks 1, 2, 6, 12 and 24. After evidence of consolidation (between the 6th and 10th weeks), the orthotics were removed. One patient complained of pain in the immediate postoperative period and, at the end of the 1st year, only one patient presented pain during rehabilitation, which was completely resolved with analgesics. Currently, the patients do not present complaints, returning to activities without restrictions – one of them, to the practice of soccer and rappelling. The postoperative AOFAS AHS was from 68 to 86 points.
Keywords
ankle joint - arthrodesis - osteoarthritis - minimally invasive surgical procedures - surgical procedures, operative - ankle* Work developed in the Groups of Foot and Ankle Surgery and Orthopedic Oncology, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brazil.
Publikationsverlauf
Eingereicht: 22. September 2020
Angenommen: 15. Januar 2021
Artikel online veröffentlicht:
25. Oktober 2021
© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Referências
- 1 Saltzman CL, Salamon ML, Blanchard GM. et al. Epidemiology of ankle arthritis: report of a consecutive series of 639 patients from a tertiary orthopaedic center. Iowa Orthop J 2005; 25: 44-46
- 2 Baumbach SF, Massen FK, Hörterer S. et al. Comparison of arthroscopic to open tibiotalocalcaneal arthrodesis in high-risk patients. Foot Ankle Surg 2019; 25 (06) 804-811
- 3 Vilà y Rico J, Rodriguez-Martin J, Parra-Sanchez G, Marti Lopez-Amor C. Arthroscopic tibiotalocalcaneal arthrodesis with locked retrograde compression nail. J Foot Ankle Surg 2013; 52 (04) 523-528
- 4 Coughlin MJ, Nery C, Baumfeld D, Jastifer J. Artrodese tibiotársica compressiva com o uso de placa bloqueada lateral. Rev Bras Ortop 2012; 47 (05) 611-615
- 5 Biz C, Hoxhaj B, Aldegheri R, Iacobellis C. Minimally invasive surgery for tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail: preliminary results of an innovative modified technique. J Foot Ankle Surg 2016; 55 (06) 1130-1138
- 6 Rodrigues RC, Masiero D, Mizusaki JM. et al. Translation, cultural adaptation and validity of the american orthopaedic foot and ankle society (AOFAS) ankle-hindfoot scale. Acta Ortop Bras 2008; 16 (02) 107-111
- 7 Lee BH, Fang C, Kunnasegaran R, Thevendran G. Tibiotalocalcaneal arthrodesis with the hindfoot arthrodesis nail: a prospective consecutive series from a single institution. J Foot Ankle Surg 2018; 57 (01) 23-30
- 8 Rammelt S, Pyrc J, Agren PH. et al. Tibiotalocalcaneal fusion using the hindfoot arthrodesis nail: a multicenter study. Foot Ankle Int 2013; 34 (09) 1245-1255
- 9 Brodsky JW, Verschae G, Tenenbaum S. Surgical correction of severe deformity of the ankle and hindfoot by arthrodesis using a compressing retrograde intramedullary nail. Foot Ankle Int 2014; 35 (04) 360-367
- 10 Thomas AE, Guyver PM, Taylor JM, Czipri M, Talbot NJ, Sharpe IT. Tibiotalocalcaneal arthrodesis with a compressive retrograde nail: A retrospective study of 59 nails. Foot Ankle Surg 2015; 21 (03) 202-205