Tibiotalocalcaneal arthrodesis with retrograde intramedullary nailing: What differs only approach change?

IF 1.9 Q2 ORTHOPEDICS
Kamil Balaban, Ramazan Akmeşe, Hüseyin Hakan Kınık, Mahmut Kalem
{"title":"Tibiotalocalcaneal arthrodesis with retrograde intramedullary nailing: What differs only approach change?","authors":"Kamil Balaban, Ramazan Akmeşe, Hüseyin Hakan Kınık, Mahmut Kalem","doi":"10.52312/jdrs.2025.2380","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to compare the clinical and radiographic outcomes of open (lateral transfibular) and arthroscopic joint debridement techniques in tibiotalocalcaneal arthrodesis (TTCA) using the same nail system.</p><p><strong>Patients and methods: </strong>Between January 2011 and December 2022, a total of 62 patients (21 males, 41 females; mean age 53.81±16.68 years; range 18 to 82 years) who underwent TTCA with retrograde intramedullary nail were retrospectively analyzed. The patients were classified as open (n=30) or arthroscopy (n=32) based on the method used for joint debridement. Data including demographic characteristics, pre-and postoperative radiographs, skin-to-skin operative times, and fluoroscopy times were recorded. Tibiotalar and subtalar union rates, coronal and sagittal ankle alignment examined through coronal tibiotalar (CTT) and sagittal tibiotalar (STT) angles were also noted. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS-AHS) and Visual Analog Scale (VAS). Complications were evaluated.</p><p><strong>Results: </strong>A total of 34 ankles (n=30) underwent open TTCA, while 34 ankles (n=32) had arthroscopic TTCA. Baseline characteristics and follow-up duration were similar between the groups (p>0.05). The overall fusion rate (tibiotalar and subtalar) was 94.1% in the open group and 85.3% in the arthroscopic group (p=0.425). Both open and arthroscopy groups achieved satisfactory coronal and sagittal ankle alignment. The median CTT angles were 94° and 91°, and STT angles were 109° and 112°, respectively. The arthroscopy group had significantly shorter operative time, fluoroscopy time, and hospital stay (p<0.001, p=0.019, p<0.001, respectively). No significant differences were found in complication rates, postoperative AOFAS-AHS, and VAS scores (p>0.05).</p><p><strong>Conclusion: </strong>Both open and arthroscopic TTCA approaches yielded similar radiographic and clinical outcomes. Based on these findings, we can speculate that the arthroscopic technique may offer advantages in perioperative efficiency, suggesting it is a viable alternative in appropriately selected patients.</p>","PeriodicalId":73560,"journal":{"name":"Joint diseases and related surgery","volume":"36 3","pages":"711-723"},"PeriodicalIF":1.9000,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456346/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Joint diseases and related surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.52312/jdrs.2025.2380","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives: This study aims to compare the clinical and radiographic outcomes of open (lateral transfibular) and arthroscopic joint debridement techniques in tibiotalocalcaneal arthrodesis (TTCA) using the same nail system.

Patients and methods: Between January 2011 and December 2022, a total of 62 patients (21 males, 41 females; mean age 53.81±16.68 years; range 18 to 82 years) who underwent TTCA with retrograde intramedullary nail were retrospectively analyzed. The patients were classified as open (n=30) or arthroscopy (n=32) based on the method used for joint debridement. Data including demographic characteristics, pre-and postoperative radiographs, skin-to-skin operative times, and fluoroscopy times were recorded. Tibiotalar and subtalar union rates, coronal and sagittal ankle alignment examined through coronal tibiotalar (CTT) and sagittal tibiotalar (STT) angles were also noted. Functional outcomes were measured using the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score (AOFAS-AHS) and Visual Analog Scale (VAS). Complications were evaluated.

Results: A total of 34 ankles (n=30) underwent open TTCA, while 34 ankles (n=32) had arthroscopic TTCA. Baseline characteristics and follow-up duration were similar between the groups (p>0.05). The overall fusion rate (tibiotalar and subtalar) was 94.1% in the open group and 85.3% in the arthroscopic group (p=0.425). Both open and arthroscopy groups achieved satisfactory coronal and sagittal ankle alignment. The median CTT angles were 94° and 91°, and STT angles were 109° and 112°, respectively. The arthroscopy group had significantly shorter operative time, fluoroscopy time, and hospital stay (p<0.001, p=0.019, p<0.001, respectively). No significant differences were found in complication rates, postoperative AOFAS-AHS, and VAS scores (p>0.05).

Conclusion: Both open and arthroscopic TTCA approaches yielded similar radiographic and clinical outcomes. Based on these findings, we can speculate that the arthroscopic technique may offer advantages in perioperative efficiency, suggesting it is a viable alternative in appropriately selected patients.

Abstract Image

Abstract Image

Abstract Image

胫距跟骨关节融合术伴逆行髓内钉:入路改变有何不同?
目的:本研究的目的是比较开放(外侧经腓骨)和关节镜下的关节清创技术在使用相同的指甲系统的胫距跟骨关节融合术(TTCA)中的临床和影像学结果。患者与方法:2011年1月至2022年12月,共62例患者(男21例,女41例;平均年龄53.81±16.68岁;回顾性分析18 ~ 82岁)行逆行髓内钉行TTCA的患者。根据关节清创方法将患者分为切开(30例)和关节镜(32例)两组。数据包括人口统计学特征、术前和术后x线片、皮肤对皮肤手术次数和透视次数。还记录了通过冠状胫距角(CTT)和矢状胫距角(STT)检查的胫距和距下愈合率,冠状面和矢状面踝关节对齐。功能结果采用美国骨科足踝学会踝关节-后足评分(AOFAS-AHS)和视觉模拟量表(VAS)进行测量。评估并发症。结果:34例踝关节(n=30)行开放性TTCA, 34例踝关节(n=32)行关节镜TTCA。两组间基线特征和随访时间相似(p < 0.05)。开放组胫距和距下的整体融合率为94.1%,关节镜组为85.3% (p=0.425)。开放组和关节镜组均获得满意的冠状面和矢状面踝关节对准。中位CTT角度分别为94°和91°,STT角度分别为109°和112°。关节镜组手术时间、透视时间、住院时间均显著缩短(p0.05)。结论:开放和关节镜下的TTCA入路具有相似的影像学和临床结果。基于这些发现,我们可以推测关节镜技术可能在围手术期效率方面具有优势,这表明在适当选择的患者中,它是一种可行的替代方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.50
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信