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Mid-term follow-up of patients with hindfoot arthrodesis with retrograde compression intramedullary nail in Charcot neuroarthropathy of the hindfoot.
Bone Joint J. 2018 Feb; 100-B(2):190-196.BJ

Abstract

AIMS

Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up.

PATIENTS AND METHODS

We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail. Patients were ten men and eight women with a mean age of 63.43 years (38.5 to 79.8). We report the rate of limb salvage, complications requiring additional surgery, and fusion rate in both groups. The mean duration of follow-up was 46.36 months (37 to 70).

RESULTS

The limb salvage rate was 16 of 19 limbs. Three patients had to undergo below-knee amputation due to persistent infection followed by osteomyelitis resistant to parenteral antibiotic therapy and repeated debridement. Complications including infection, hardware removal, nonunion, and persistent ulcers requiring further intervention were also observed. Postoperative functional scores revealed significant improvement compared with preoperative scores on American Orthopaedic Foot and Ankle Society (AOFAS) - Hindfoot scale, Foot Function Index (FFI), visual analogue scale (VAS), and Foot and Ankle Outcome Score (FAOS).

CONCLUSION

The use of retrograde intramedullary compression nail results in good rates of limb salvage when used for hindfoot reconstruction in patients with Charcot arthropathy. Cite this article: Bone Joint J 2018;100-B:190-6.

Authors+Show Affiliations

Orthopaedic Hospital Speising, Speisingerstrasse 109, A-1130, Vienna, Austria.Orthopaedic Hospital Speising, Speisingerstrasse 109, A-1130, Vienna, Austria.King Saud University, P. O. Box 7805, Riyadh 11472, Saudi Arabia.Fusszentrum Wien, Alserstrasse 43/8d, 1080, Vienna, Austria.Orthopaedic Hospital Speising, Speisingerstrasse 109, A-1130, Vienna, Austria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29437061

Citation

Chraim, M, et al. "Mid-term Follow-up of Patients With Hindfoot Arthrodesis With Retrograde Compression Intramedullary Nail in Charcot Neuroarthropathy of the Hindfoot." The Bone & Joint Journal, vol. 100-B, no. 2, 2018, pp. 190-196.
Chraim M, Krenn S, Alrabai HM, et al. Mid-term follow-up of patients with hindfoot arthrodesis with retrograde compression intramedullary nail in Charcot neuroarthropathy of the hindfoot. Bone Joint J. 2018;100-B(2):190-196.
Chraim, M., Krenn, S., Alrabai, H. M., Trnka, H. J., & Bock, P. (2018). Mid-term follow-up of patients with hindfoot arthrodesis with retrograde compression intramedullary nail in Charcot neuroarthropathy of the hindfoot. The Bone & Joint Journal, 100-B(2), 190-196. https://doi.org/10.1302/0301-620X.100B2.BJJ-2017-0374.R2
Chraim M, et al. Mid-term Follow-up of Patients With Hindfoot Arthrodesis With Retrograde Compression Intramedullary Nail in Charcot Neuroarthropathy of the Hindfoot. Bone Joint J. 2018;100-B(2):190-196. PubMed PMID: 29437061.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mid-term follow-up of patients with hindfoot arthrodesis with retrograde compression intramedullary nail in Charcot neuroarthropathy of the hindfoot. AU - Chraim,M, AU - Krenn,S, AU - Alrabai,H M, AU - Trnka,H-J, AU - Bock,P, PY - 2018/2/14/entrez PY - 2018/2/14/pubmed PY - 2018/2/17/medline KW - Ankle fusion KW - Charcot arthropathy KW - Diabetes mellitus KW - Hindfoot arthrodesis KW - Subtalar joint KW - Tibiotalar joint KW - Tibiotalocalcaneal nail SP - 190 EP - 196 JF - The bone & joint journal JO - Bone Joint J VL - 100-B IS - 2 N2 - AIMS: Hindfoot arthrodesis with retrograde intramedullary nailing has been described as a surgical strategy to reconstruct deformities of the ankle and hindfoot in patients with Charcot arthropathy. This study presents case series of Charcot arthropathy patients treated with two different retrograde intramedullary straight compression nails in order to reconstruct the hindfoot and assess the results over a mid-term follow-up. PATIENTS AND METHODS: We performed a retrospective analysis of 18 consecutive patients and 19 operated feet with Charcot arthropathy who underwent a hindfoot arthrodesis using a retrograde intramedullary compression nail. Patients were ten men and eight women with a mean age of 63.43 years (38.5 to 79.8). We report the rate of limb salvage, complications requiring additional surgery, and fusion rate in both groups. The mean duration of follow-up was 46.36 months (37 to 70). RESULTS: The limb salvage rate was 16 of 19 limbs. Three patients had to undergo below-knee amputation due to persistent infection followed by osteomyelitis resistant to parenteral antibiotic therapy and repeated debridement. Complications including infection, hardware removal, nonunion, and persistent ulcers requiring further intervention were also observed. Postoperative functional scores revealed significant improvement compared with preoperative scores on American Orthopaedic Foot and Ankle Society (AOFAS) - Hindfoot scale, Foot Function Index (FFI), visual analogue scale (VAS), and Foot and Ankle Outcome Score (FAOS). CONCLUSION: The use of retrograde intramedullary compression nail results in good rates of limb salvage when used for hindfoot reconstruction in patients with Charcot arthropathy. Cite this article: Bone Joint J 2018;100-B:190-6. SN - 2049-4408 UR - https://www.unboundmedicine.com/medline/citation/29437061/Mid_term_follow_up_of_patients_with_hindfoot_arthrodesis_with_retrograde_compression_intramedullary_nail_in_Charcot_neuroarthropathy_of_the_hindfoot_ L2 - https://online.boneandjoint.org.uk/doi/10.1302/0301-620X.100B2.BJJ-2017-0374.R2?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -