Stress fractures and tibial cortical hypertrophy after tibiotalocalcaneal arthrodesis with an intramedullary nail.
Twelve patients underwent successful tibiotalocalcaneal arthrodesis using a locked intramedullary nail with posterior moldable bone grafting. Two of the patients developed a nondisplaced stress fracture around the proximal interlocking screws, which responded to immobilization at 8 and 15 months after surgery. In 7 of 12 patients, > or =2 mm of cortical hypertrophy was noted between the proximal interlocking screws along the medial and/or lateral aspect of the tibia. Although intramedullary nailing can achieve satisfactory tibiotalocalcaneal arthrodesis, the stress risers in the tibial diaphyses do result in a stress reaction in a significant number of patients.
Thordarson
D B
DB
Department of Orthopaedics, University of Southern California, Los Angeles 90033, USA.
Chang
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000009:adverse effects* / Q000295:instrumentation; D001858:Bone Nails / Q000009:adverse effects*; D001863:Bone Screws / Q000009:adverse effects*; D002111:Calcaneus / Q000601:surgery; D005260:Female; D015775:Fractures, Stress / Q000209:etiology*; D006801:Humans; D006984:Hypertrophy; D008297:Male; D008875:Middle Aged; D013380:Subtalar Joint / Q000601:surgery; D013628:Talus / Q000601:surgery; D013977:Tibia / Q000473:pathology* / Q000601:surgery; D013978:Tibial Fractures / Q000209:etiology*