Abstract
Aim: To report the clinical and radiological results of patients undergoing hindfoot fusion using an intramedullary nail. Methods: Retrospective review of notes of patients undergoing combined ankle and subtalar arthrodesis using retrograde intramedullary nailing. The procedure is performed mainly for the treatment of complex hindfoot deformities or following failed total ankle arthroplasty. Outcome was assessed by notes review, clinical examination and telephone questionnaire. Results: Between 1995 and 2001 56 arthrodeses in 52 patients have been performed. The average follow up is 3 years. Approach to the joints was via an anterolateral incision unless previous surgery dictated otherwise. All cases utilised an ACE¨ humeral nail which was locked proximally and distally. Most procedures utilised bone graft from the þbula, proximal tibia, iliac crest or allograft femoral head. Mean tourniquet time was 114 mins. Post-operative management generally consisted of 3 months plaster immobilisation. Post-operative complications included deep infection, amputation, stress fracture, non-union & prominent metalwork. At review 90% of patients were satisþed and approximately 90% felt the pain level & function of their foot had improved. Average postoperative AOFAS hindfoot score was 65. Conclusion: Hindfoot fusion by intramedullary nailing is an effective technique in complex cases of deformity and in many cases is the only alternative to amputation. Patient satisfaction appears to be high but the procedure is demanding and the complication rate can be signiþcant.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
