Advertisement

Change in Height Following Tibiotalocalcaneal Arthrodesis: Retrospective Radiographic Analysis

Published:November 20, 2022DOI:https://doi.org/10.1053/j.jfas.2022.11.009

      Abstract

      Tibiotalocalcaneal arthrodesis (TTCA) with an intramedullary rod is a viable treatment option for a myriad of pathologies involving the foot and ankle. While the current literature has focused on fixation techniques, deformity correction, and clinical outcomes, we are unaware of any studies specifically examining change in height following a TTCA. In the present study, we retrospectively analyzed radiographs with novel radiographic techniques to determine the change in height from preoperative to postoperative radiographs following TTCA. Patients were divided into three categories: Charcot, arthritis, and pes planus as the indication for surgical intervention. We found that Charcot and arthritis had an average decrease in height on anterior and posterior measurements of the height from the distal tibia to the calcaneus, while pes planus had an increase in height. The average Charcot change in height was -12.0 ± 24.4mm anteriorly and -7.6 ± 15.5mm posteriorly. The average change in height for the arthritis group was -6.9 ± 6.7mm anteriorly and -3.8 ± 5.8mm posteriorly. The pes planus group was found to have an average increase in height 0.5 ± 8.0mm anteriorly and 2.9 ± 5.8mm posteriorly. Overall, we found a statistically significant difference in height change between the three groups in anterior measurements (p- value= 0.012) and posterior measurement (p-value= 0.006). We recommend surgeons who perform this procedure to be aware of the potential change in height to better tailor surgical and postoperative care.
      LOC: 3

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The Journal of Foot and Ankle Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      REFERENCES

        • Burns PR
        • Dunse A.
        Tibiotalocalcaneal Arthrodesis for Foot and Ankle Deformities.
        Clin Podiatr Med Surg. 2017 Jul; 34 (PMID: 28576195): 357-380https://doi.org/10.1016/j.cpm.2017.02.007
        • Burks JB.
        Tibiotalocalcaneal arthrodesis.
        Clin Podiatr Med Surg. 2012 Oct; 29 (PMID: 23044061): 529-545https://doi.org/10.1016/j.cpm.2012.08.002
        • Donnenwerth MP
        • Roukis TS.
        Tibio-talo-calcaneal arthrodesis with retrograde compression intramedullary nail fixation for salvage of failed total ankle replacement: a systematic review.
        Clin Podiatr Med Surg. 2013 Apr; 30 (Epub 2012 Nov 26. PMID: 23465809): 199-206https://doi.org/10.1016/j.cpm.2012.10.007
        • Franceschi F.
        • Franceschetti E.
        • Torre G.
        • et al.
        Tibiotalocalcaneal arthrodesis using an intramedullary nail: a systematic review.
        Knee Surg Sports Traumatol Arthrosc. 2016; 24 (doi-org.wake.idm.oclc.org/): 1316-1325https://doi.org/10.1007/s00167-015-3548-1
        • Goebel M
        • Gerdesmeyer L
        • Mückley T
        • Schmitt-Sody M
        • Diehl P
        • Stienstra J
        • Bühren V.
        Retrograde intramedullary nailing in tibiotalocalcaneal arthrodesis: a short-term, prospective study.
        J Foot Ankle Surg. 2006; 45 (Mar-AprPMID: 16513504): 98-106https://doi.org/10.1053/j.jfas.2005.12.001
        • Brodsky JW
        • Verschae G
        • Tenenbaum S.
        Surgical correction of severe deformity of the ankle and hindfoot by arthrodesis using a compressing retrograde intramedullary nail.
        Foot Ankle Int. 2014 Apr; 35 (Epub 2014 Feb 6. PMID: 24505043): 360-367https://doi.org/10.1177/1071100714523270
        • Gordon JE
        • Davis LE.
        Leg Length Discrepancy: The Natural History (And What Do We Really Know).
        J Pediatr Orthop. 2019 Jul; 39 (PMID: 31169640): S10-S13https://doi.org/10.1097/BPO.0000000000001396
        • Berend ME
        • Glisson RR
        • Nunley JA.
        A biomechanical comparison of intramedullary nail and crossed lag screw fixation for tibiotalocalcaneal arthrodesis.
        Foot Ankle Int. 1997 Oct; 18 (PMID: 9347301): 639-643https://doi.org/10.1177/107110079701801007
        • Alfahd U
        • Roth SE
        • Stephen D
        • Whyne CM
        Biomechanical comparison of intramedullary nail and blade plate fixation for tibiotalocalcaneal arthrodesis.
        J Orthop Trauma. 2005; 19: 703-708
        • Bennett GL
        • Cameron B
        • Njus G
        • Saunders M
        • Kay DB.
        Tibiotalocalcaneal arthrodesis: a biomechanical assessment of stability.
        Foot Ankle Int. 2005; 26: 530-536
        • Budnar VM
        • Hepple S
        • Harries WG
        • Livingstone JA
        • Winson I
        Tibiotalocalcaneal arthrodesis with a curved, interlocking, intramedullary nail.
        Foot Ankle Int. 2010; 31: 1085-1092
        • Hammett R
        • Hepple S
        • Forster B
        • Winson I.
        Tibiotalocalcaneal (hindfoot) arthrodesis by retrograde intramedullary nailing using a curved locking nail: the results of 52 procedures.
        Foot Ankle Int. 2005; 26: 810-815
        • Vogt B
        • Gosheger G
        • Wirth T
        • Horn J
        • Rödl R.
        Leg Length Discrepancy- Treatment Indications and Strategies.
        Dtsch Arztebl Int. 2020 Jun 12; 117 (PMID: 32865491; PMCID: PMC7477698): 405-411https://doi.org/10.3238/arztebl.2020.0405
        • Khamis S
        • Carmeli E.
        Relationship and significance of gait deviations associated with limb length discrepancy: A systematic review.
        Gait Posture. 2017 Sep; 57 (Epub 2017 May 31. PMID: 28600975): 115-123https://doi.org/10.1016/j.gaitpost.2017.05.028
        • Boer R
        • Mader K
        • Pennig D
        • Verheyen CC
        Tibiotalocalcaneal arthrodesis using a reamed retrograde locking nail.
        Clin Orthop Relat Res. 2007; 463: 151-156