title: Minimally Invasive Surgery for Tibiotalocalcaneal Arthrodesis Using a Retrograde Intramedullary Nail: Preliminary Results of an Innovative Modified Technique.
abstract: The aim of the present longitudinal prospective study was to evaluate the clinical, functional, and radiologic outcomes and patient satisfaction of those who had undergone minimally invasive surgery (MIS) for tibiotalocalcaneal arthrodesis with an intramedullary nail. The 28 patients, who had consecutively undergone surgery with the MIS technique, were evaluated clinically and radiographically at 1, 2, 3, and 6 months after surgery and at last follow-up examination. For the clinical evaluation, the American Orthopaedic Foot and Ankle Society scale and visual analog scale for the foot and ankle were used in the preoperative and final follow-up examinations. The patients rated their satisfaction on a scale from 0 to 10. The mean score obtained with the American Orthopaedic Foot and Ankle Society scale was 68.28 ± 5.02 (range 58 to 74) points and with the visual analog scale for the foot and ankle was 70.76 ± 7.72 (range 58 to 82) points, with a mean follow-up of 25.07 ± 6.32 (range 6 to 40) months. The clinical improvement was statistically significant with both types of evaluation (p ≤ .05), comparing the preoperative and follow-up periods. Fusion was achieved in all patients, with a mean fusion time of 14.85 ± 4.12 (range 8 to 56) weeks. The alignment of the ankle and foot was optimal in 27 of 28 patients (96.42%), and patient satisfaction was rated as 6.71 ± 1.37 (range 5 to 10) points. Finally, the use of MIS for tibiotalocalcaneal arthrodesis with intramedullary nail results in fusion of the articulation with a low complication rate.
authors.affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy. Electronic address: carlo.biz@unipd.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Biz
authors.affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy.
authors.forename: Bramir
authors.initials: B
authors.lastname: Hoxhaj
authors.affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Aldegheri
authors.affiliation: Orthopaedic Clinic, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padova, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Iacobellis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001174:Arthrodesis / Q000295:instrumentation / Q000379:methods*; D001858:Bone Nails; D005260:Female; D033023:Foot Joints; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: IM nail; ankle fusion; calcaneus; hindfoot arthrodesis; percutaneous; talus; tibia