Does the Subtalar or Tibiotalar Joint Need Fused in Primary Retrograde Tibiotalocalcaneal Nailing for Fragility Ankle Fractures?

Autor:	DeGenova DT; Department of Orthopedics, OhioHealth, Columbus, Ohio., Hill ZP; Department of Foot and Ankle Surgery, OhioHealth, Columbus, Ohio., Hoffman AD; Department of Orthopedics, Mercy Health St. Elizabeth Youngstown Hospital, Youngstown, Ohio., Taylor AR; Orthopedic and Reconstructive Surgery, OhioHealth Grant Medical Center, Department of Orthopedic Surgery, Columbus Ohio., Dues B; Orthopedic and Reconstructive Surgery, OhioHealth Grant Medical Center, Department of Orthopedic Surgery, Columbus Ohio., Faherty M; Academic Research Services, OhioHealth Research Institute, Riverside Methodist Hospital, Columbus, Ohio., Taylor BC; Orthopedic and Reconstructive Surgery, OhioHealth Grant Medical Center, Department of Orthopedic Surgery, Columbus Ohio.
Jazyk:	angličtina
Zdroj:	Foot & ankle specialist [Foot Ankle Spec] 2024 May 10, pp. 19386400241249583. Date of Electronic Publication: 2024 May 10.
DOI:	10.1177/19386400241249583
Abstrakt:	Background: As an alternative to traditional open reduction internal fixation of ankle fragility fractures, primary retrograde tibiotalocalcaneal (TTC) nailing has been investigated as a treatment option. These results suggest that this treatment is an acceptable alternative treatment option for these injuries. There are still questions about the need for formal joint preparation at the subtalar or tibiotalar joint when performing primary TTC nailing for fragility fractures. Methods: In this study, we retrospectively evaluated 32 patients treated with primary retrograde TTC nail without subtalar or tibiotalar joint preparation for a mean of 2.4 years postoperatively. We specifically reviewed the charts for nail breakages at either joint, patients developing subtalar or tibiotalar joint pathology requiring additional treatment, including return to the operating room for formal joint preparation. Results: Fracture union occurred in 100% of patients. There were 3 cases (10.0%) of hardware failure, and 2 of these cases were asymptomatic and did not require any treatment. One patient (3.3%) developed hardware failure with nail breakage at the subtalar joint. This patient developed progressive pain and symptoms requiring revision surgery with formal arthrodesis of the subtalar and tibiotalar joint. Conclusions: This study shows that retrograde hindfoot nailing without formal subtalar or tibiotalar joint preparation is an acceptable potential treatment option in ankle fragility fractures. Mid-term follow-up demonstrates favorable outcomes without the need for formal joint preparation in this high-risk population. Comparative studies with higher patient numbers and long-term follow-up are needed to confirm the results of this study. Levels of Evidence: Level IV. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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