title: Influencing factors of functional result and bone union in tibiotalocalcaneal arthrodesis with intramedullary locking nail: a retrospective series of 30 cases.
abstract: BACKGROUND
  Initially considered as an established salvage procedure for tibiotalocalcaneal arthrodesis (TTCA), intramedullary nailing indications have expanded as evidenced in recent literature. We have tried to identify factors influencing functional result and bone union.
  
  
  METHODS
  In a retrospective study, 30 patients were treated by a TTCA between January 2006 and November 2011. Indications, operative technique, bone fusion, X-rays and functional result [American Foot and Ankle Society (AOFAS) and short-form health survey (SF-36) scores] before and after surgery were registered and analyzed.
  
  
  RESULTS
  Thirty cases of TTCA were included. The patient's average age was 52 (range 24-90). Union rate was 86% for the tibiotalar joint and 74% for the subtalar joint with an average follow-up of 25.4 months (8-67). The mean AOFAS' score significantly improved (from 37 to 59) as the SF-36' score. Global complication rate was about 56%. It has not been possible to identify factors significantly influencing bone fusion or functional results. All septic cases achieved fusion without any septic resurgence.
  
  
  CONCLUSIONS
  Retrograde intramedullary nailing in TTCA is an effective technique, which allows good clinical results even in case of septic history of the patient. Fusion rate and functional results were not significantly influenced by any of the factors examined in this study.
authors.affiliation: Service COT Hôpital Central, 29 avenue de Lattre de Tassigny, 54000, Nancy, France, jeanbaptiste.gross@gmail.com.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Gross
authors.forename: Rémi
authors.initials: R
authors.lastname: Belleville
authors.forename: Arnaud
authors.initials: A
authors.lastname: Nespola
authors.forename: Jean-Manuel
authors.initials: JM
authors.lastname: Poircuitte
authors.forename: Henry
authors.initials: H
authors.lastname: Coudane
authors.forename: Didier
authors.initials: D
authors.lastname: Mainard
authors.forename: Laurent
authors.initials: L
authors.lastname: Galois
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000601:surgery; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D001858:Bone Nails; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D004185:Disability Evaluation; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013628:Talus / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult