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Tibiotalocalcaneal arthrodesis using an intramedullary nail: a systematic review

  • Ankle
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Tibiotalocalcaneal arthrodesis is aimed to block the ankle joint motion in cases of severe osteoarthritis, avascular necrosis of the talus and/or failure of arthroplasty operations. This systematic review was carried out to evaluate the clinical outcome after tibiotalocalcaneal arthrodesis using intramedullary nail either open and arthroscopically assisted. Focus was on the success rate of the procedure in terms of union and complications and on the comparison between the techniques.

Methods

The databases PubMed (Medline), EMBASE and Cochrane Library were searched in order to retrieve relevant studies. All therapeutic level 1–4 studies involving humans with intramedullary nail fixation technique were included. Only studies written in English, Italian, French, Spanish and German were included. Data related to the type of surgery, complications and clinical outcomes were extracted and analysed.

Results

A total of 83 studies were identified, of which 32 studies were eligible for inclusion; 31 case series and one randomized controlled trial. The main reported outcome score was the American Orthopaedic Foot and Ankle Society scale. Almost, all the included studies reported higher than 50 % union rates and a significant improvement in terms of the clinical and mechanical ankle function after treatment.

Conclusions

Results suggest that satisfactory outcomes can be achieved by tibiotalocalcaneal arthrodesis using intramedullary nailing. Low complication rates contribute to make this a safe procedure. No comparison can be done between arthroscopic and open technique, due to the lack of scientific works on the first one.

Level of evidence

IV.

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Authors and Affiliations

  1. Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo, Rome, Italy

    Francesco Franceschi, Edoardo Franceschetti, Guglielmo Torre, Rocco Papalia & Vincenzo Denaro

  2. Department of Orthopaedics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

    Kristian Samuelsson & Jón Karlsson

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  1. Francesco Franceschi
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  2. Edoardo Franceschetti
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Correspondence to Edoardo Franceschetti.

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Franceschi, F., Franceschetti, E., Torre, G. et al. Tibiotalocalcaneal arthrodesis using an intramedullary nail: a systematic review. Knee Surg Sports Traumatol Arthrosc 24, 1316–1325 (2016). https://doi.org/10.1007/s00167-015-3548-1

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  • DOI: https://doi.org/10.1007/s00167-015-3548-1

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