title: Complications of tibio-talar-calcaneal fusion using intramedullary nails.
abstract: BACKGROUND
  Hindfoot nails are being increasingly used, however significant complications can occur. The purpose of this study was to assess the complications following the use of hindfoot nails at our institution.
  
  
  METHODS
  We identified patients from a retrospective database. All underwent hindfoot nailing under the care of the senior author. Details of complications were recorded.
  
  
  RESULTS
  We identified 52 patients undergoing 55 procedures. Mean follow up was 44.8 months (18-69). Forty patients achieved ankle fusion and 36 subtalar joint fusion. Complications included prominent metalwork in 13 patients, CRPS in five and one peri-prosthetic fracture. Nine developed deep infection, and of these limb salvage was achieved in six patients by removal of metalwork, debridement and insertion of antibiotic loaded cement beads. The remaining three patients underwent below knee amputation.
  
  
  CONCLUSIONS
  Significant complications can occur, although limb preservation was possible in most cases of deep infection. Hindfoot nailing should be reserved as salvage procedure.
authors.affiliation: Foot And Ankle Unit, Royal Orthopaedic Hospital, Birmingham, UK. Electronic address: Fenton1977@hotmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Fenton
authors.affiliation: Foot And Ankle Unit, Royal Orthopaedic Hospital, Birmingham, UK.
authors.forename: N
authors.initials: N
authors.lastname: Bali
authors.affiliation: Foot And Ankle Unit, Royal Orthopaedic Hospital, Birmingham, UK.
authors.forename: R
authors.initials: R
authors.lastname: Matheshwari
authors.affiliation: Foot And Ankle Unit, Royal Orthopaedic Hospital, Birmingham, UK.
authors.forename: B
authors.initials: B
authors.lastname: Youssef
authors.affiliation: Foot And Ankle Unit, Royal Orthopaedic Hospital, Birmingham, UK.
authors.forename: K
authors.initials: K
authors.lastname: Meda
mesh_terms: D000328:Adult; D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000843:Ankle Joint / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001174:Arthrodesis / Q000295:instrumentation*; D001843:Bone Cements; D001858:Bone Nails / Q000009:adverse effects*; D002111:Calcaneus / Q000601:surgery*; D020918:Complex Regional Pain Syndromes / Q000209:etiology; D003646:Debridement; D020878:Device Removal; D005500:Follow-Up Studies; D006801:Humans; D023821:Limb Salvage; D008875:Middle Aged; D057068:Periprosthetic Fractures / Q000209:etiology; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D013380:Subtalar Joint / Q000601:surgery*; D013628:Talus / Q000601:surgery*; D013977:Tibia / Q000601:surgery*; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D001843:Bone Cements
keywords: Complications; Hindfoot nail