title: Pantalar arthrodesis for post-traumatic arthritis and diabetic neuroarthropathy of the ankle and hindfoot.
abstract: BACKGROUND
  Pantalar arthrodesis is an important salvage option for stabilizing the hindfoot and salvaging the limb following trauma or collapse. This report evaluates the healing rates and complications which occur in diabetics and post-traumatic patients.
  
  
  METHODS
  Twenty patients presenting with post-traumatic arthritis of the ankle-hindfoot (twelve) or with Type II or Type IIIA Charcot arthropathy (eight) were managed with a pantalar fusion. Followup averaged 46 months. Patients were evaluated using the Short Form-36 (SF-36), the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score, the Short Musculoskeletal Function Assessment (SMFA) and the Visual Analog Pain Scale (VAS).
  
  
  RESULTS
  There were no amputations in either group. Casting averaged 14.9 weeks, full weightbearing was achieved at 25.1 weeks and time to union averaged 44.1 weeks. Average age was 56.3 yrs. and BMI averaged 34.2. Fourteen patients (70%) had their surgery performed in multiple stages. Acceptable outcomes were noted for all patients for the SF-36, AOFAS and SMFA scores. VAS scores averaged 2.2. There were ten complications (50%); four patients (two in each group) required additional surgery.
  
  
  CONCLUSIONS
  Pantalar arthrodesis is a reasonable salvage option for patients with severe post traumatic arthropathy and neuropathic arthropathy. Patients should be informed of the increased risks as well as the long periods of postoperative immobilization and nonweightbearing. We believe a pantalar arthrodesis can produce acceptable outcomes regardless of the cause of disability, with a staged or single approach, and whether the surgery is performed with plates and screws or an intramedullary device.
authors: Trauma and Foor/Ankle Services, Tampa General Hospital, Tampa, FL, USA. fixbones@aol.com
authors: Dolfi
authors: D
authors: Herscovici
authors: G James
authors: GJ
authors: Sammarco
authors: V James
authors: VJ
authors: Sammarco
authors: Julia M
authors: JM
authors: Scaduto
mesh_terms: D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000150:complications; D000843:Ankle Joint / Q000601:surgery*; D001168:Arthritis / Q000209:etiology / Q000601:surgery*; D001174:Arthrodesis / Q000379:methods*; D001177:Arthropathy, Neurogenic / Q000601:surgery*; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016879:Salvage Therapy; D013628:Talus / Q000601:surgery*; D016474:Weight-Bearing