Louis-Marie Pessey, Alexandre Sabaté Ferris, Matthieu Peras, Emilie Bilichtin, Bernard de Geofroy, Olivier Barbier, Camille Choufani
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引用次数: 0
Abstract
Purpose: To evaluate the efficacy of tibiotalocalcaneal arthrodesis using retrograde nailing (TTCAN) in post-traumatic conditions with high septic risk. We hypothesized that this minimally invasive technique would achieve bone union and satisfactory functional recovery without increasing septic risk.
Methods: A prospective single-centre observational study included 20 patients who underwent TTCAN between January 2020 and December 2023. The primary outcome was the complete joint fusion rate at six months. Secondary outcomes included pain assessment, complications, functional evaluation using the modified AOFAS score, and quality of life assessment using the SF-12 questionnaire.
Results: Complete tibiotalocalcaneal fusion was achieved in 55% of patients at six months. Diabetes was significantly associated with fusion failure (p = 0.026). For nonunion cases (n = 14), the consolidation rate reached 78.6% at six months and 92.9% at final follow-up. The mean modified AOFAS score was 48.4 ± 17.5 at six months, improving to 51.2 ± 19.3 at final follow-up (mean 15.6 months). Quality of life assessment showed greater impact on physical (PCS-12: 32.0 ± 6.9) than mental (MCS-12: 47.0 ± 12.7) components. Complications included delayed healing (25%) and one superficial infection.
Conclusion: TTCAN proves to be a reliable salvage solution for complex ankle and hindfoot trauma in high-risk septic contexts, enabling limb preservation with acceptable functional outcomes and minimal complications.
期刊介绍：
International Orthopaedics, the Official Journal of the Société Internationale de Chirurgie Orthopédique et de Traumatologie (SICOT) , publishes original papers from all over the world. The articles deal with clinical orthopaedic surgery or basic research directly connected with orthopaedic surgery. International Orthopaedics will also link all the members of SICOT by means of an insert that will be concerned with SICOT matters.
Finally, it is expected that news and information regarding all aspects of orthopaedic surgery, including meetings, panels, instructional courses, etc. will be brought to the attention of the readers.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.
Reports of animal experiments must state that the "Principles of laboratory animal care" (NIH publication No. 85-23, revised 1985) were followed, as well as specific national laws (e.g. the current version of the German Law on the Protection of Animals) where applicable.
The editors reserve the right to reject manuscripts that do not comply with the above-mentioned requirements. The author will be held responsible for false statements or for failure to fulfil the above-mentioned requirements.
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