Abstract
Tibiotalocalcaneal arthrodesis is a salvage procedure for various end-stage foot and
ankle pathologic entities. Several factors are known to influence the union rate after
these procedures, including construct rigidity. The data on locked plates as a fixation
technique have been inconclusive, with variable union rates reported. One recent study
suggested that locking plates can lead to high nonunion rates owing to excessive rigidity.
The purpose of the present study was to retrospectively examine the outcomes of locking
plate fixation. We retrospectively reviewed the cases of 15 patients (7 [46.7%] male,
8 [53.3%] female) who underwent tibiotalocalcaneal, tibiocalcaneal, or tibiotalar
arthrodesis fixed with a locking plate from January 2013 to January 2014. The average
age was 52.19 ± 5.8 years. The mean follow-up period was 17 ± 5.3 months. We examined
the overall union rates and the effects of smoking, diabetes, and rheumatologic status
on the union rate. Of the 15 cases, 11 (73.3%) did not achieve union. The mean time
to failure was 10 ± 5.3 months. Age, gender, smoking, diabetes, use of augmentation
screws outside the plate, and operating surgeon did not have an effect on the failure
rate (p > .50). In addition, gender, smoking, and diabetes did not predict for nonunion.
The high failure rate of rigid locking plate fixation reported might be attributable
to the high incidence of smoking and diabetic comorbidities in our study. However,
excessive construct rigidity might play an important role. Larger studies are needed
to establish more reliable union rates with the use of locking plates in foot and
ankle fusion.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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