[Tibiotalar arthrodesis with the tibial compression nail]

Area of Science:

• Orthopedic Surgery
• Reconstructive Surgery
• Trauma Surgery

Background:

• Ankle osteoarthritis often presents with debilitating pain and functional limitations.
• Conservative treatments may fail, particularly in cases with poor bone quality or prior pilon fractures.
• Ankle arthrodesis is a surgical option for end-stage ankle joint disease.

Purpose of the Study:

• To evaluate the efficacy and outcomes of ankle arthrodesis using a compression nail.
• To assess the rate of bony fusion and patient-reported outcomes.
• To identify complications associated with this surgical technique.

Main Methods:

• A lateral approach with malleolus resection was employed.
• Articular cartilage was removed, and wedge resection was performed if axial correction was needed.
• A compression nail was inserted into the tibia and talus, followed by compression osteosynthesis and bone grafting.

Main Results:

• Successful bony fusion was achieved in 90% of 110 patients followed for 42 months.
• Revision surgery with recompression and bone grafting was successful in 5.5% of cases.
• Nonunion occurred in 4.5% of patients, with various complications reported including infections and subtalar osteoarthritis.

Conclusions:

• Ankle arthrodesis with a compression nail is an effective treatment for severe ankle osteoarthritis, yielding high rates of bony fusion.
• The procedure can provide pain relief and improve function, even in patients with compromised bone quality.
• Potential complications should be considered, and careful patient selection and surgical technique are crucial for optimal outcomes.