Intramedullary Nailing in Ankle Arthrodesis: Antegrade vs Retrograde

Abstract

This prospective study compares the clinical results of antegrade and retrograde intramedullary arthrodesis of the upper and lower ankle joint using dynamic interlocking nails with the possibility of axial compression. In 13 patients combined arthrodesis was performed using a retrograde femur nail inserted through the heel, whereas in 18 patients tibiotalocalcaneal arthrodesis was performed using a distal tibia nail through an antegrade approach. Patients were evaluated in a standardized examination using criteria of SF 36 focussing on approach, osseous consolidation and quality of life. Both techniques yielded good results: bony consolidation was achieved in 85-89 % after the mean follow up time. In 74-81 % pain was reduced effectively using the intramedullary nail arthrodesis, quality of life was improved drastically. 3 non-unions occurred, 1 implant failure was reported and there were 2 infections. The advantage of the retrograde technique is the non-invasivity of the proximal tibial. Using antegrade as well as plantar approach, intramedullary nail arthrodesis of the ankle is a suitable technique with very good results for combined arthrodesis of the upper and lower ankle joint.

Key words

Tibiotalocalcaneal - arthrodesis - intramedullary nailing - ankle arthrodesis

References

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