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Tibiotalocalcaneal

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https://www.readbyqxmd.com/read/28587485/management-of-nonunited-talar-fractures-with-avascular-necrosis-by-resection-of-necrotic-bone-bone-grafting-and-fusion-with-an-intramedullary-nail
#1
Mohamed Mokhtar Abd-Ella, Ahmed Galhoum, Amr Farouk Abdelrahman, Markus Walther
BACKGROUND: The presence of nonunion of a talar fracture with displacement, together with complete avascular necrosis, is a challenging entity to treat. METHODS: Twelve patients, 8 men (66.7%) and 4 women (33.3%), with nonunited talar fractures and extensive avascular necrosis of the talus were included. The average age was 27.7 years (range, 19-38 years). After exclusion of infection, the patients underwent resection of necrotic bone, bulk autograft, and fusion using an intramedullary nail...
June 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28576195/tibiotalocalcaneal-arthrodesis-for-foot-and-ankle-deformities
#2
REVIEW
Patrick R Burns, Augusta Dunse
Tibiotalocalcaneal arthrodesis is a safe and viable option to treat patients with arthridities affecting ankle and subtalar joints, neuromuscular disorders, avascular necrosis of the talus, failed ankle arthrodesis, instability, and Charcot neuroarthropathy. Choice of incision and fixation is based on deformity, pathology, prior surgery and hardware, and surgeon comfort and preference. Intramedullary nails offer high primary stability, reduce sustained soft tissue damage, and may allow for earlier return to activities than traditional plate or screw constructs...
July 2017: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/28552043/tibiotalocalcaneal-arthrodesis-using-a-soft-tissue-preserved-fibular-graft-for-treatment-of-large-bone-defects-in-the-ankle
#3
Kota Watanabe, Atsushi Teramoto, Takuma Kobayashi, Izaya Ogon, Yuzuru Sakakibara, Tomoaki Kamiya, Tomoyuki Suzuki, Toshihiko Yamashita
BACKGROUND: Pathogenesis of ankle disorders with a large bone defect is varied and treatment for those problems is challenging for orthopaedic surgeons. The aims of this study were to present an operative technique of arthrodesis for the reconstruction of the ankle and hindfoot with a large bone defect using a soft tissue-preserved fibular strut graft and to report outcomes of consecutively treated patients. METHODS: Twelve feet from 11 patients, including feet with aseptic necrosis of the talus and total ankle implant loosening, were treated...
June 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28497248/-aseptic-loosening-of-total-ankle-replacement-one-stage-revision-ankle-arthroplasty
#4
G Pagenstert, M D Wimmer, M Jacxsens, C L Saltzman, A Barg
OBJECTIVE: To revise one or both loosened prosthesis components, to achieve postoperative pain relief, and preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components without substantial bone defect of the tibial or talar bone stock. CONTRAINDICATIONS: General surgical or anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy (e...
May 11, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28476401/tibiotalocalcaneal-arthrodesis-with-intramedullary-fibular-strut-graft-with-adjuvant-hardware-fixation
#5
Ashish B Shah, Caleb Jones, Osama Elattar, Sameer M Naranje
Tibiotalocalcaneal arthrodesis (TTCA) is a well-established operative procedure for different severe pathologic conditions of the ankle and hindfoot joints. We present our results with a modified technique of TTCA using an intramedullary fibular strut graft in a series of complex cases of patients treated for multiple etiologies shown to have improved union rates. The technique involves inserting the fibular strut graft intramedullary after joint preparation and the use of either a Taylor spatial frame or plate and screws for definitive fixation...
May 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28442207/tibio-talo-calcaneal-fusion-after-limb-salvage-procedures-a-retrospective-study
#6
Lukas Zak, Gerald E Wozasek
BACKGROUND: The treatment of limb threatening trauma on the distal tibia or hindfoot often results in posttraumatic osteoarthritis requiring tibiotalocalcaneal (TTC) arthrodesis. The purpose of this study was to present a case series of patients undergoing various techniques of joint fusion after bone reconstruction and deformity correction as a salvage procedure. The study should help trauma surgeons making decisions in limb salvage and deformity correction in complex lower leg and foot injuries by presenting options and treatment strategies...
April 15, 2017: Injury
https://www.readbyqxmd.com/read/28349756/extruded-talus-treated-with-reimplantation-and-primary-tibiotalocalcaneal-arthrodesis
#7
H R Mohammad, J A'Court, A Pillai
Extruded talus is a rare serious result from a high-energy injury to a supinated and plantar flexed foot. Treatment remains controversial with a lack of congruent evidence for talar reimplantation. A 34-year-old woman was involved in a road traffic accident at 40 mph. Imaging revealed a left talus extruded anterolaterally with a talar neck fracture. Additional injuries included right acetabular fracture, transverse process fractures and rib fractures, which were treated conservatively. The talus was reimplanted and the talar neck fixed with a cortical screw...
April 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28183211/3d-optical-investigation-of-2-nail-systems-used-in-tibiotalocalcaneal-arthrodesis-a-biomechanical-study
#8
Julia Evers, Martin Lakemeier, Dirk Wähnert, Martin Schulze, Martinus Richter, Michael J Raschke, Sabine Ochman
BACKGROUND: Although retrograde intramedullary nails for tibiotalocalcaneal arthrodesis (TTCA) are an established fixation method, few studies have evaluated the stability of the available nail systems. The purpose of this study was to compare biomechanically the primary stability of 2 nail-systems, A3 (Small Bone Innovations) and HAN (Synthes), in human cadavers and analyze the exact point of instability in TTCA by means of optical measurement. METHODS: In 6 pairs of lower legs (n = 12) of fresh-frozen human cadavers with osteoporotic bone structure, bone mineral density (BMD) was determined...
May 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27920334/technique-for-use-of-trabecular-metal-spacers-in-tibiotalocalcaneal-arthrodesis-with-large-bony-defects
#9
Christopher Kreulen, Evan Lian, Eric Giza
There are many causes of large bone defects in the tibiotalar joint that need to be definitively treated with a tibiotalocalcaneal (TTC) arthrodesis. Some of the challenges of a large defect are its effect on leg length and the complications associated with trying to fill the defect with structural bone graft. We present an operative strategy involving the use of a trabecular metal implant, a TTC nail that utilized 2 forms of compression, and Reamer/Irrigator/Aspirator (RIA) autograft, to address limitations of previous operative approaches and reliably treat this operative challenge...
January 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27908492/fragility-fractures-of-the-ankle-in-the-elderly-open-reduction-and-internal-fixation-versus-tibio-talo-calcaneal-nailing-short-term-results-of-a-prospective-randomized-controlled-study
#10
D Georgiannos, V Lampridis, I Bisbinas
INTRODUCTION: The management of ankle fractures in the elderly remains unpredictable, secondary to their various co-morbidities. Although tibiotalocalcaneal (TTC) nailing has been an effective option for ankle arthrodesis due to ankle arthritis or Charcot arthropathy there are few reports regarding the use of TTC nail for the treatment of ankle fractures. PURPOSE: Aim of this study was to compare the results of ORIF versus TTC nailing for the treatment of unstable ankle fractures in the elderly...
February 2017: Injury
https://www.readbyqxmd.com/read/27821660/limb-salvage-after-failed-initial-operative-management-of-bimalleolar-ankle-fractures-in-diabetic-neuropathy
#11
Nicholas J Vaudreuil, Mitchell S Fourman, Dane K Wukich
BACKGROUND: Ankle fractures in patients with diabetes mellitus (DM) can be difficult to manage, especially in the presence of peripheral neuropathy. In patients who fail initial operative management, attempts at limb salvage can be challenging, and no clear treatment algorithm exists. This study examined outcomes of different procedures performed for limb salvage in this population. METHODS: This study retrospectively reviewed 17 patients with DM complicated by peripheral neuropathy who sustained a bimalleolar ankle fracture and failed initial operative management...
March 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27698177/intramedullary-nailing-and-external-ring-fixation-for-tibiotalocalcaneal-arthrodesis-in-charcot-arthropathy
#12
James Richman, Adam Cota, Steven Weinfeld
BACKGROUND: Surgical strategies to address deformities of the ankle and hindfoot in patients with Charcot arthropathy include the use of retrograde intramedullary nails and ring fixators. The literature has not shown superiority of one technique over the other. This study presents a single surgeon's case series of Charcot arthropathy patients treated with either a ring fixator or retrograde intramedullary nail to achieve tibiotalocalcaneal arthrodesis. METHODS: We performed a retrospective analysis of 27 consecutive patients with Charcot arthropathy who underwent a tibiotalocalcaneal arthrodesis using either a retrograde intramedullary (IM) nail (n = 16 patients) or a ring fixator (RF) (n = 11 patients) by a single surgeon...
February 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/27542719/tibiotalocalcaneal-arthrodesis-with-headless-compression-screws
#13
Ji-Cheng Gong, Bing-Hua Zhou, Xu Tao, Cheng-Song Yuan, Kang-Lai Tang
BACKGROUND: Tibiotalocalcaneal arthrodesis with headless compression screws has not been previously reported. We hypothesized that these screws could be suitable for tibiotalocalcaneal arthrodesis because of their special design. This study aimed to evaluate the clinical outcomes of patients undergoing tibiotalocalcaneal arthrodesis with headless compression screws for the treatment of severe arthropathy of the ankle and subtalar joint. METHODS: From 2010 to 2015, 23 patients with severe ankle and subtalar arthropathy underwent tibiotalocalcaneal arthrodesis...
August 19, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27528840/primary-retrograde-tibiotalocalcaneal-nailing-for-fragility-ankle-fractures
#14
Benjamin C Taylor, Dane C Hansen, Ryan Harrison, Douglas E Lucas, Daniel Degenova
BACKGROUND: Ankle fragility fractures are difficult to treat due to poor bone quality and soft tissues as well as the near ubiquitous presence of comorbidities including diabetes mellitus and peripheral neuropathy. Conventional open reduction and internal fixation in this population has been shown to lead to a significant rate of complications. Given the high rate of complications with contemporary fixation methods, the present study aims to critically evaluate the use of acute hindfoot nailing as a percutaneous fixation technique for high-risk ankle fragility fractures...
2016: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/27524730/minimally-invasive-surgery-for-tibiotalocalcaneal-arthrodesis-using%C3%A2-a%C3%A2-retrograde-intramedullary-nail-preliminary-results-of%C3%A2-an%C3%A2-innovative-modified-technique
#15
Carlo Biz, Bramir Hoxhaj, Roberto Aldegheri, Claudio Iacobellis
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...
November 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27519965/tibiotalocalcaneal-arthrodesis-by-using-proximal-humeral-locking-plate
#16
Devrim Özer, Avni İlhan Bayhan, Abdi Keskin, Seçkin Sarı, Mehmet Akif Kaygusuz
OBJECTIVES: The aim of this study was to evaluate the short-term clinical and radiological results of tibiotalocalcaneal arthrodesis (TTCA) with proximal humeral locking plate. MATERIAL AND METHODS: Eight patients (7 female, 1 male; average age 53 years (range: 24-67)) who underwent TTCA with proximal humeral locking plate between 2009 and 2011, were retrospectively evaluated with AOFAS hindfoot scale and Maryland foot score system. The mean follow up was 32.6 months (range: 23-54)...
August 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27472925/a-modified-and-enhanced-test-setup-for-biomechanical-investigations-of-the-hindfoot-for-example-in-tibiotalocalcaneal-arthrodesis
#17
Julia Evers, Martin Schulze, Dominic Gehweiler, Martin Lakemeier, Michael J Raschke, Dirk Wähnert, Sabine Ochman
BACKGROUND: Tibiotalocalcaneal arthrodesis (TTCA) using intramedullary nails is a salvage procedure for many diseases in the ankle and subtalar joint. Despite "newly described intramedullary nails" with specific anatomical shapes there still remain major complications regarding this procedure. The following study presents a modified biomechanical test setup for investigations of the hindfoot. METHODS: Nine fresh-frozen specimens from below the human knee were anaysed using the Hindfoot Arthrodesis Nail (Synthes) instrument...
2016: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/27392451/-internal-circular-arc-osteosynthesis-of-tibiotalocalcaneal-arthrodesis
#18
Kaj Klaue, H Zwipp, T Mittlmeier, N Espinosa
Tibiotalocalcaneal arthrodesis has recently become more popular as a form of reconstructive surgery. The precise anatomical orientation and the functional extrinsic musculature of the hindfoot are essential for a satisfactory result. Fixation of the arthrodesis is a mechanical problem. Straight and angulated nails are not anatomically or mechanically ideal. A circular arc nail can fix the tibia, the talus and the calcaneus in anatomical alignment. This is a pure "bone nail", in contrast to the "intramedullary nail," which is driven through an existing opening in long bones...
October 2016: Der Unfallchirurg
https://www.readbyqxmd.com/read/27390290/measurement-of-nitinol-recovery-distance-using-pseudoelastic-intramedullary-nails-for-tibiotalocalcaneal-arthrodesis
#19
Beau J Kildow, Christopher E Gross, Samuel D Adams, Selene G Parekh
Background Tibiotalocalcaneal arthrodesis is a salvage procedure for patients with complex disease of the ankle and subtalar joints. Despite the clinical efficacy and mechanical advantage of intramedullary nails, complications, such as nonunion, are common. It may be possible to sustain compression in the face of bone resorption and implant loosening over the course of healing using a novel pseudoelastic intramedullary nail with an internal nitinol element. Methods We identified 15 patients with average age of 54...
July 7, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27390289/revision-tibiotalocalcaneal-arthrodesis-with-a-pseudoelastic-intramedullary-nail
#20
L Daniel Latt, Kathryn Elizabeth Smith, Kenneth Michael Dupont
Hindfoot (tibiotalocalcaneal or TTC) arthrodesis is commonly used to treat concomitant arthritis of the ankle and subtalar joints. Simultaneous fusion of both joints can be difficult to achieve especially in patients with impaired healing due to smoking, diabetes mellitus, or Charcot neuroarthropathy. Conventional intramedullary fixation devices allow for compression to be applied at the time of surgery, but this compression can be lost due to bone resorption or settling, leading to impaired healing. In contrast, the novel pseudoelastic intramedullary nail is designed to maintain compression at the arthrodesis sites throughout the healing process by the use of an internal pseudoelastic element...
February 2017: Foot & Ankle Specialist
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