title: Short-term outcome of retrograde tibiotalocalcaneal arthrodesis with a curved intramedullary nail.
abstract: BACKGROUND
  The aim of this study was to investigate the potential clinical benefit of tibiotalocalcaneal arthrodesis (TTCA) with an intramedullary nail with a valgus curve, two compression options, and angle-stable locking.
  
  
  METHODS
  Patients who had undergone TTCA at two tertiary hospitals were eligible. Patients who had undergone TTCA before the beginning of the study were evaluated retrospectively, then all following patients were examined prospectively. There were 59 TTCAs; 55 patients were available for analysis. Twenty-eight were evaluated retrospectively, 27 prospectively. Main Outcome Measures were an SF-36, Mazur-, and AOFAS ankle-hindfoot rating scores and radiographic examination.
  
  
  RESULTS
  Bony union was obtained in 53 patients. Fifty-one patients were satisfied with the outcome. Fifty-one patients had marked subjective improvement in mobility. The mean AOFAS score of the 55 patients at the latest followup was 66.8 (range, 38 to 86). The mean Mazzur score was 68.0 (range, 30 to 83). In the prospective group, the scores were significantly improved: AOFAS score by an average of 39.6 points (p<0.001); Mazur score by an average of 43 points (p<0.001); SF-36 physical component summary score (p<0.001) and mental component summary score also improved (p<0.048). Radiology showed good hindfoot alignment. The complication rate was 25%.
  
  
  CONCLUSIONS
  Compared with the literature, the data obtained in this study show a good outcome and a high rate of bony union, with comparable complication rates. Patient satisfaction was good. However, the patients still had limitations. The clinical benefit of the nail used was confirmed.
authors.affiliation: University Hospital Jena, Department of Trauma, Hand and Reconstructive Surgery, Erlanger Allee 101, Jena, 07747, Germany. Thomas.Mueckley@med.uni-jena.de
authors.forename: Thomas
authors.initials: T
authors.lastname: Mückley
authors.forename: Kajetan
authors.initials: K
authors.lastname: Klos
authors.forename: Thomas
authors.initials: T
authors.lastname: Drechsel
authors.forename: Claudia
authors.initials: C
authors.lastname: Beimel
authors.forename: Florian
authors.initials: F
authors.lastname: Gras
authors.forename: Gunther O
authors.initials: GO
authors.lastname: Hofmann
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D001858:Bone Nails; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D013628:Talus / Q000000981:diagnostic imaging / Q000601:surgery*; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome