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Subtalar fusion

Christiane Kruppa, Tyler Snoap, Debra L Sietsema, Thomas A Schildhauer, Marcel Dudda, Clifford B Jones
The outcomes of pediatric talus fractures have been minimally reported in published studies. The purpose of the present retrospective study was to determine the clinical and radiographic outcomes after talus fractures in pediatric and adolescent patients and to define the differences among the different age groups in this population. A total of 52 children and adolescents (54 fractures) with 24 type 1 (44.44%), 13 type 2 (24.07%), 8 type 3 (14.81%), and 9 type 4 (16.67%) Marti-Weber fractures were considered...
March 2, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
N Vasukutty, H Jawalkar, A Anugraha, R Chekuri, R Ahluwalia, V Kavarthapu
BACKGROUND: Corrective fusion for the unstable deformed hind foot and mid foot in Charcot Neuroarthropathy (CN) is quite challenging and is best done in tertiary centres under the supervision of multidisciplinary teams. METHODS: We present a follow up to our initial report with a series of 42 hind foot corrections in 40 patients from a tertiary level teaching hospital in the United Kingdom. The mean patient age was 59 (33-82). 17 patients had type1diabetes mellitus, 23 had type 2...
April 28, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
S Aubret, L Merlini, M Fessy, J L Besse
INTRODUCTION: One of the reasons for revision of total ankle replacement (TAR) implants is loosening due to subchondral cysts. Reconstruction and fusion of the ankle is often the first choice for revision procedures due to the large bone defects, which are typically filled with autograft and/or allograft. Filling the defect with a trabecular metal tantalum implant is a potential alternative given the biomechanical properties of this component. HYPOTHESIS: Using tantalum as a spacer provides primary stability and contributes to fusion of the ankle joint after removal of failed TAR implants...
January 30, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Christopher Robert Jones, Eric Wong, Gregory R Applegate, Richard D Ferkel
PURPOSE: The purpose of our study was to determine the results of arthroscopic ankle arthrodesis (AAA) and how the procedure affects adjoining joints and functional scores. METHODS: Between 1993 and 2013, 116 patients (120 ankles) underwent AAA. Nineteen ankles were lost to follow-up due to death, insufficient radiographic studies, or inability to contact, resulting in 97 patients (101 ankles). Mean age at surgery was 61.1 years (range, 35.8-79.6 years); mean follow-up was 86 months (range, 24-247 months)...
January 25, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ariel Palanca, Roger A Mann, Jeffrey A Mann, Andrew Haskell
BACKGROUND: Over the past decade, total ankle arthroplasty (TAA) has become a mainstay in the treatment of end-stage ankle arthritis. Currently in its fourth generation, the Scandanavian Total Ankle Replacement (STAR) is the only 3-piece mobile bearing ankle prosthesis available in the United States. Our current study reports implant survivorship at 15 years and patient outcomes for a subset of these survivors available for study. METHODS: Eighty-four TAAs were performed between 1998 and 2000...
February 2018: Foot & Ankle International
Alessio Bernasconi, Claude Guillard, François Lintz
The effectiveness of subtalar arthrodesis has been well documented in treating degenerative subtalar joint disease. The arthroscopic subtalar approach for arthrodesis has also been proved to give excellent results in terms of bone fusion rates and reduction of wound-related pain and complications. To date, the main concerns about arthroscopy have regarded incision-related neurologic complications such as lesions of the tibial, fibular, and sural nerves. In this context, we present a 2-portal lateral (anterior and middle) approach to arthroscopic subtalar arthrodesis, recently documented in the literature, that provides similar excellent access to the joint with a lower risk of nerve damage...
August 2017: Arthroscopy Techniques
Ann Heble, Melanie D Everitt, Jane Gralla, Shelley D Miyamoto, Michael Lahart, Jennifer Eshelman
mTOR inhibitors have been associated with SWC when used in the perioperative period. Limited literature is available to guide providers in managing chronic mTOR inhibitor use in the perioperative period, especially in the pediatric setting. The primary aim of this study was to describe the prevalence of SWC with mTOR inhibitor continuation during the perioperative period for major surgeries. Heart transplant recipients ≤25 years old at the time of primary heart transplant receiving sirolimus maintenance therapy during a surgical procedure and within the study period were included...
February 2018: Pediatric Transplantation
Michael Dujela, Christopher F Hyer, Gregory C Berlet
BACKGROUND: Hindfoot arthritis or significant deformity involving the ankle and subtalar joint (STJ) is a disabling condition with few salvage options. Many surgeons note a decreased STJ fusion rate compared with ankle union when a retrograde nail construct is used. The purpose of this study was to report the STJ fusion rate of tibiotalocalcaneal (TTC) arthrodesis with retrograde nail. METHODS: A chart and radiographic review was performed. TTC fusions performed in patients with osteoarthritis, posttraumatic arthritis, or deformity correction with retrograde nail fixation were included...
November 1, 2017: Foot & Ankle Specialist
Bing Howe Lee, Christopher Fang, Remesh Kunnasegaran, Gowreeson Thevendran
Tibiotalocalcaneal arthrodesis (TTCA) is a salvage procedure. We report a series of 20 patients who underwent TTCA using an intramedullary nail. Of the 20 patients, 7 (35%) had diabetes mellitus. The patient experiences and outcomes were analyzed. Their mean age was 61.1 (range 39 to 78) years. The minimum follow-up period was 13 (mean 28, range 13 to 49) months. Surgical indications included diabetic Charcot arthropathy in 7 (35%), hindfoot osteoarthritis in 10 (50%), and severe equinovarus deformity in 3 (15%)...
January 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Sergio Eckholt, Ruben Garcia-Elvira, Nicolás Fontecilla, Alvaro Fernandez-Reinales, Daniel Poggio
BACKGROUND: Tibiotalocalcaneal (TTC) arthrodesis is a procedure commonly used as salvage surgery for various pathologic processes that compromise the ankle and subtalar joints. It is a reasonably standardized procedure when performed as a primary surgery in advanced stages of TTC arthritis. For such cases, there are several alternative approaches, fixation materials, and bone substitutes that can be used. Most represent valid options with similar results in the literature. However, in highly complex cases requiring TTC arthrodesis, the options for the approach and fixation material can be limited...
February 2018: Foot & Ankle International
Mandeep Singh Dhillon, Vikas Agashe, Sampat Dumbre Patil
BACKGROUND: Tuberculosis of the foot and ankle still remains to be a significant problem, especially in the developing countries, and with an increase in incidence in immunosuppressed patients. Treatment is mainly medical using multidrug chemotherapy; surgical interventions range from biopsy, synovectomy and debridement, to joint preserving procedures like distraction in early cases, and arthrodesis of hindfoot joints and the ankle in advanced disease with joint destruction. Surgical Options: All procedures should be done after initiating appropriate medical management...
2017: Open Orthopaedics Journal
Ashish Shah, Sameer Naranje, Ibukunoluwa Araoye, Osama Elattar, Alexandre Leme Godoy-Santos, Cesar DE Cesar
OBJECTIVES: The purpose of this study was to compare union rates for isolated subtalar arthrodesis with and without the use of bone grafts or bone graft substitutes. METHODS: We retrospectively reviewed 135 subtalar fusions with a mean follow-up of 18 ± 14 months. The standard approach was used for all surgeries. Graft materials included b-tricalcium phosphate, demineralized bone matrix, iliac crest autograft and allograft, and allograft cancellous chips. Successful subtalar fusion was determined clinically and radiographically...
September 2017: Acta Ortopedica Brasileira
Travis Junge, Jaime Bellamy, Thomas Dowd, Patrick Osborn
BACKGROUND: Talus fractures are infrequent injuries that are often associated with poor clinical outcomes. Literature reviewing talus fractures is limited to a civilian population, with few studies characterizing these injuries sustained in active duty personnel. The aim of this study was to characterize talus fractures sustained in combat trauma by reporting their surgical outcomes. METHODS: The Department of Defense Trauma Registry (DoDTR) was queried to identify US service members who sustained talus fractures in battle conditions between 2001 and 2014...
December 2017: Foot & Ankle International
Travis J Dekker, David Walton, Emily N Vinson, Kamran S Hamid, Andrew E Federer, Mark E Easley, James K DeOrio, James A Nunley, Samuel B Adams
BACKGROUND: The purpose of this study was to assess the radiographic progression of subtalar and talonavicular degenerative joint disease in a series of patients who had undergone TAA (total ankle arthroplasty) with minimum follow-up of 5 years. METHODS: TAA patient radiographs from a single institution were analyzed for peritalar arthritic changes by extrapolating the modified Kellgren Lawrence (KL) grades of the knee to the subtalar and talonavicular joints. Patients were included if they had a minimum of 5 years of follow-up...
November 2017: Foot & Ankle International
Jian Fan, X Zhang, Y Luo, G W You, W K Ng, Y F Yang
BACKGROUND: Tibiotalocalcaneal arthrodesis is most common and effective surgical treatment for severe hindfoot pathology, but the fusion rate is often lower than the ordinary tibiotalar arthrodesis because of the more serious joint disease associated with obvious deformity and osteoporosis. Recent literature describe tibiotalocalcaneal arthrodesis with reverse PHILOS plate with good clinical outcome result, though some patients non-union, due to eccentric force of the plate may be hidden...
July 24, 2017: BMC Musculoskeletal Disorders
Ermias Abebe, Dana J Farrell, Boris Zelle, Gary Gruen
A subset of C2/C3 pilon fractures, open pilon injuries, metaphyseal bone comminution, and those involving substantial soft tissue or vascular injury may be nonreconstructable. Such injuries are at risk of progress to nonunion and failing open reduction internal fixation (ORIF). The risk of infection, malunion, and nonunion is relatively high with such injury patterns. In such cases, tibiotalar arthrodesis is performed after ORIF fails as a salvage procedure. Overall, the literature agrees that all pilon fractures will develop posttraumatic osteoarthritis, and these patients are ultimately treated with an arthrodesis or in narrow population with total ankle arthroplasty...
August 2017: Journal of Orthopaedic Trauma
M Herrera-Pérez, J Boluda-Mengod, M J Gutierrez-Morales, J L Pais-Brito
Tibiotalocalcaneal arthrodesis is an effective salvage procedure in cases of combined ankle and subtalar osteoarthritis as well as severe multiplanar deformities and severe joint destruction of the hindfoot. Special mention should be made of this procedure in cases of bone loss, especially from the talus, secondary to failed previous surgeries or bone infection, often being the only way to achieve a stable and painless foot and ankle. We present a case of ankle fracture in a patient with associated morbidity and multiple complications following osteosynthesis, in which tibiotalocalcaneal arthrodesis with cemented with antibiotic coated retrograde nail has achieved a satisfactory final result...
July 3, 2017: Revista Española de Cirugía Ortopédica y Traumatología
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...
August 2017: Foot & Ankle International
Jie Wen, Hong Liu, Sheng Xiao, Xin Li, Ke Fang, Ming Zeng, Zhongwen Tang, Shu Cao, Fanling Li
To compare the treatment efficacy of spastic flatfoot surgery by 2 different surgical methods: nonfusion subtalar arthroereisis using subtalar joint stabilizer (SJS) and Dennyson-Fulford subtalar arthrodesis (D-FSA).A total of 26 cases of ambulant children with cerebral palsy diagnosed as spastic flatfoot were surgically treated from January 2011 to December 2014. Preoperative and postoperative American Orthopedic Foot and Ankle Society-Ankle and Hindfoot (AOFAS-AH) scores, anteroposterior-talocalcaneal angles (ATAs), and lateral talar-first metatarsal angles (Meary angles) of the affected foot were recorded...
June 2017: Medicine (Baltimore)
Ernest J Hollman, Quirine M J van der Vliet, Georgios Alexandridis, Falco Hietbrink, Luke P H Leenen
INTRODUCTION: Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis, a condition frequently seen in patients who suffered major trauma. Functional outcomes in trauma patients may be influenced by concomitant injuries and the severity of the initial trauma. The aim of this study was to evaluate quality of life and functional outcomes of subtalar arthrodesis for posttraumatic arthritis in patients with severe or complex foot injuries. MATERIALS AND METHODS: This is a retrospective single center study with prospective follow-up...
July 2017: Injury
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