title: Tibiocalcaneal arthrodesis as a limb salvage procedure for complex hindfoot deformities.
abstract: BACKGROUND
  Tibiocalcaneal (TC) arthrodesis is a limb salvage method for patients with severe deformities combined with necrosis and/or luxation of the talus. The aim of this study was to examine the clinical and radiological outcome of TC arthrodesis.
  
  
  METHODS
  This retrospective study identified 12 patients with luxation and/or necrosis of the talus, due to charcot neuroarthropathy (83.3 %) or traumatic injuries (16.7 %). All patients underwent TC arthrodesis by an external fixator or nail arthrodesis. The mean follow up was 18 (6-36) months with a mean age of 51.3 (30-66) years. The data were collected using the AOFAS score as well as clinical and radiological examination during regular follow up.
  
  
  RESULTS
  Seven (58.3 %) patients were treated with an external fixator, four (33.3 %) with nail arthrodesis and one (8.3 %) patient rejected both fixation methods. Four (100 %) patients achieved radiological and clinical bone union after nail arthrodesis and four (57.1 %) patients after external fixation. Three (42.9 %) patients treated by an external fixator showed a radiological moderate bone fusion, but a stable, asymptomatic non-union. One (8.3 %) case ended up in transfemoral amputation. Eleven patients (91.7 %) regained independent mobilization. The mean AOFAS score improved from 24.3 preoperatively to 66.7 postoperatively (p < 0.05). The postoperative satisfaction rate was good to excellent in 83.3 %.
  
  
  CONCLUSIONS
  TC arthrodesis is a promising and effective method for the treatment of severe ankle deformities with talus luxation. It allows patient's return to mobility with good to excellent patient satisfaction.
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ettinger
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.
authors.forename: Christina
authors.initials: C
authors.lastname: Stukenborg-Colsman
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Plaass
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.
authors.forename: Daiwei
authors.initials: D
authors.lastname: Yao
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.
authors.forename: Leif
authors.initials: L
authors.lastname: Claassen
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Berger
authors.affiliation: Department for Foot and Ankle Surgery, Hessing Stiftung, Hessingstraße 17, 86199, Augsburg, Germany.
authors.forename: Hazibullah
authors.initials: H
authors.lastname: Waizy
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany.
authors.forename: Christoph Maria
authors.initials: CM
authors.lastname: Becher
authors.affiliation: Department of Orthopaedic Surgery, Hannover Medical School, Anna-von-Borries-Straße 1-7, 30625, Hannover, Germany. kraj@gmx.net.
authors.forename: Kiriakos
authors.initials: K
authors.lastname: Daniilidis
mesh_terms: D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000601:surgery*; D000843:Ankle Joint / Q000473:pathology / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D002607:Charcot-Marie-Tooth Disease / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018409:Foot Injuries / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D023821:Limb Salvage / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000601:surgery; D012189:Retrospective Studies; D013628:Talus / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Charcot arthropathy; Diabetes; Hindfoot deformities; Limb salvage; Non-union