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. 2023 Jan 20:9:862133.
doi: 10.3389/fsurg.2022.862133. eCollection 2022.

Functional outcomes of tibiotalocalcaneal arthrodesis using a hindfoot arthrodesis nail in treating Charcot's arthropathy deformity

Mohd Yazid Bajuri  1 , Ammar Muizuddin Manas  1 , Kamarul Syarazi Zamri  1
Affiliations

Functional outcomes of tibiotalocalcaneal arthrodesis using a hindfoot arthrodesis nail in treating Charcot's arthropathy deformity

Mohd Yazid Bajuri et al. Front Surg. .

Abstract

Background: Tibiotalocalcaneal arthrodesis or hindfoot fusion is a salvage surgical option used to treat symptomatic or severe deformity as a result of Charcot's arthropathy. It is an internal fixation that utilizes nails to stabilize the hindfoot after surgical correction of the deformity. This study intends to measure the change in functional outcomes of patients with Charcot's arthropathy using this technique and the time taken to achieve fusion.

Method: This study presents a series of 40 cases of Charcot's arthropathy where hindfoot fusion was done using a hindfoot arthrodesis nail. A retrospective analysis was done where these patients' functional scores had been evaluated preoperatively and postoperatively (serially) with the Short-Form Health Survey 36 (SF-36), American Orthopedic Foot and Ankle Society (AOFAS), Foot and Ankle Outcome Score (FAOS), and Foot Function Index (FFI). Along with its complication, the length of time required for the fusion is also reported.

Results: This study consists of 40 patients (13 men, 27 women; mean age 60.5 years; age range 52-68 years) with a mean follow-up of 64 months (range 24-108 months). The mean time taken for fusion was 5.1 months. All patients showed improvement in functional scoring (SF-36, AOFAS, FFI, and FAOS) postoperatively. We establish that the improvements were gradual over 2 years. Approximately 37.5% of patients had a minor complication and 2.5% had a major complication.

Conclusion: Hindfoot fusion using a hindfoot arthrodesis nail results in improved functional outcome with an acceptable fusion time and acceptable complication rate.

Level of evidence: Level III.

Keywords: Charcot’s arthropathy; foot and ankle; functional outcome; hindfoot arthrodesis nail; orthopedics.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
SF-36 physical component mean score for 2 years follow-up. SF-36, 36-Item Short-Form Health Survey.
Figure 2
Figure 2
SF-36 mental component mean score for 2 years follow-up. SF-36, 36-Item Short-Form Health Survey.
Figure 3
Figure 3
AOFAS mean score for 2 years follow-up. AOFAS, American Orthopaedic Foot & Ankle Society.
Figure 4
Figure 4
FFI mean score for 2 years follow-up. FFI, Foot Function Index.
Figure 5
Figure 5
FAOS mean score for 2 years follow-up. FAOS, Foot and Ankle Outcome Score.
Figure 6
Figure 6
(A) Example clinical pictures of one of the patient's ankle preoperatively (A) anterior view, (B) posterior view, (C) lateral view, and (D) medial view. (A,B)Varus deformity of the hindfoot which lead to abnormal weightbearing area. (C,D) Patient weightbearing on lateral aspect of the foot.
Figure 7
Figure 7
Illustrate anteroposterior (AP) and lateral radiograph of right ankle preoperative and 6 months postoperative of the same patient. (A) AP and (B) lateral radiograph shows severe ankle dislocation and medial malleolus hinging on proximal tibia cortex with consolidation of fragments indicating Eichenholtz stage 3. (C) AP and (D) lateral radiograph shows correction of deformity in plantigrade position and fused ankle joint.
See this image and copyright information in PMC

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