Revisional Hindfoot Arthrodesis

Lara J. Murphy; Robert W. Mendicino; Alan R. Catanzariti

doi:10.1016/j.cpm.2008.09.009

Living Cryopreserved Bone Allograft as an Adjunct for Hindfoot Arthrodesis

Clinics in Podiatric Medicine and Surgery ◽

10.1016/j.cpm.2018.02.002 ◽

2018 ◽

Vol 35 (3) ◽

pp. 295-310 ◽

Cited By ~ 4

Author(s):

Mark K. Magnus ◽

Kelli L. Iceman ◽

Thomas S. Roukis

Keyword(s):

Bone Allograft ◽

Hindfoot Arthrodesis

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Tibiotalar Nonunion Corrected by Hindfoot Arthrodesis

Foot & Ankle Specialist ◽

10.1177/1938640010361381 ◽

2010 ◽

Vol 3 (2) ◽

pp. 76-79 ◽

Cited By ~ 5

Author(s):

Eric Giza ◽

Annahita K. Sarcon ◽

Christopher Kreulen

Keyword(s):

Hindfoot Arthrodesis

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HINDFOOT ARTHRODESIS AND OSTEOTOMY

Key Topics in Orthopaedic Surgery ◽

10.3109/9780203381564-44 ◽

1995 ◽

pp. 154-156

Keyword(s):

Hindfoot Arthrodesis

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Does Lag Screw Retightening Improve Compression in Hindfoot Arthrodesis?

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00076 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0007

Author(s):

Amanda Rugg ◽

Melissa Requist ◽

Brooks Johnson ◽

Michelle Son ◽

Alicia Alvarez ◽

...

Keyword(s):

Stress Relaxation ◽

Causative Factor ◽

Delayed Union ◽

Direct Compression ◽

Maximum Compression ◽

Non Union ◽

Lag Screw ◽

Inferior Aspect ◽

Time Required ◽

Hindfoot Arthrodesis

Category: Hindfoot; Ankle; Ankle Arthritis Introduction/Purpose: Non-union and delayed union are common complications following hindfoot arthrodesis. The failure to obtain and maintain compression at the arthrodesis site may be a causative factor. Partially threaded cannulated ‘lag’ screws are commonly used for fixation in hindfoot arthrodesis; however, the ability of these screws to maintain compression in the hindfoot bones has not been well-characterized. The goals of this work were to: 1) quantify the stress relaxation response of hindfoot bones when compressed with a lag screw, particularly compression change upon screw retightening, and 2) compare the results to prior studies on stress relaxation in direct bone compression. Methods: 12 pairs of calcaneus, talus and tibia bone cylinders, 25mm in diameter, were cut with a keyhole saw from fresh thawed cadaveric feet. The bone cylinders were prepared for simulated arthrodesis by removing the cartilage and flattening the subchondral surface with an oscillating saw. A Futek LTH 300 donut load cell and two metal washers were sandwiched between the two bone cylinders. An 8.0mm partially threaded cannulated lag screw (Smith and Nephew) was placed from the posterior- inferior aspect of the calcaneus cylinder to the anterior-superior aspect of the talus cylinder to simulate subtalar arthrodesis, or from the superior aspect of the tibia cylinder to the inferior aspect of the talus cylinder. Compression was recorded continuously as the screws were tightened by three-quarters of a turn and left untouched for 3 minutes. Recording continued as the screws were retightened one quarter-turn and then left untouched for 30 additional minutes. Results: Both initial and subsequent compression with a lag screw demonstrated a stress relaxation pattern, with increased maximum compression and slowed decay upon retightening. Maximum compression after three quarter-turns and retightening averaged 284 N and 351 N, respectively (n=12; t=-2.55; p=0.0136). Time to decay to 80% of maximum compression after three quarter-turns and retightening averaged 34 and 528 (n=9; t=-2.59; p=0.0159) seconds, respectively, compared to 21 seconds for direct compression. Compression loss 30 minutes after retightening averaged 25.5% (SD=8.8%), compared to 34.3% for direct compression. Conclusion: The maximum compression attained following retightening was significantly greater than the maximum compression attained after initial tightening. The time required to reach 80% of maximum compression was significantly longer after subsequent compared to initial maximum compression. These findings suggest that screw retightening before surgical wound closure may slow compression loss, which could increase the likelihood of successful arthrodesis. Lag screw compression resulted in a lower percent compression loss and loss rate compared to direct compression, which was previously used to describe bone viscoelasticity.

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Association of Bosworth, Pilon, and Open Talus Fractures: A Very Unusual Ankle Trauma

Case Reports in Orthopedics ◽

10.1155/2019/6316137 ◽

2019 ◽

Vol 2019 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Kevin Moerenhout ◽

Georgios Gkagkalis ◽

Rayan Baalbaki ◽

Xavier Crevoisier

Keyword(s):

Case Report ◽

Fracture Dislocation ◽

Tibial Tubercle ◽

Medial Malleolus ◽

Distal Fibula ◽

Rare Lesion ◽

Ankle Trauma ◽

One Year ◽

Medial Malleolus Fracture ◽

Hindfoot Arthrodesis

Introduction. A Bosworth fracture-dislocation is a rare lesion resulting in a fixed dislocation of the distal fibula behind the posterior tibial tubercle. Only few cases have been reported showing an associated consequent fracture, namely, a pilon or a medial malleolus fracture. Case Report. We present a case report of a patient with an unusual combination of a Bosworth injury with a pilon fracture and an open multifragmentary talus fracture and our approach for open reduction and internal fixation. At one year postoperative, the patient developed an invalidating tibiotalar and subtalar arthrosis that eventually required an ankle-hindfoot arthrodesis. A Bosworth injury is an infrequent entity and is even rarer when associated with other fractures. Careful preoperative planning is necessary, as the combination of these fractures is a surgical challenge. Special care must be taken to preserve the neurovascular bundle. Discussion. The present case highlights a Bosworth injury involving a severity that has never been described before and suggests adding an eighth stage to the classification presented by Perry et al.

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The Midfoot Is Really Deformed After Hindfoot Arthrodesis

Foot and Ankle Clinics ◽

10.1016/j.fcl.2014.06.007 ◽

2014 ◽

Vol 19 (3) ◽

pp. 469-482

Author(s):

Paul T. Fortin

Keyword(s):

Hindfoot Arthrodesis

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Mid-term follow-up of patients with hindfoot arthrodesis with retrograde compression intramedullary nail in Charcot neuroarthropathy of the hindfoot

The Bone & Joint Journal ◽

10.1302/0301-620x.100b2.bjj-2017-0374.r2 ◽

2018 ◽

Vol 100-B (2) ◽

pp. 190-196 ◽

Cited By ~ 8

Author(s):

M. Chraim ◽

S. Krenn ◽

H. M. Alrabai ◽

H-J. Trnka ◽

P. Bock

Keyword(s):

Limb Salvage ◽

Case Series ◽

Foot And Ankle ◽

Charcot Arthropathy ◽

Charcot Neuroarthropathy ◽

Additional Surgery ◽

Functional Scores ◽

Compression Nail ◽

Hindfoot Arthrodesis

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.

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Selective Arthrodesis for Treatment of Symptomatic Müller-Weiss Disease

Foot & Ankle Orthopaedics ◽

10.1177/2473011418s00033 ◽

2018 ◽

Vol 3 (3) ◽

pp. 2473011418S0003 ◽

Cited By ~ 1

Author(s):

Le Cao ◽

Xu-dong Miao

Keyword(s):

Ct Scan ◽

Stage Iv ◽

Subjective Ratings ◽

Aofas Score ◽

Triple Arthrodesis ◽

Vas Score ◽

American Orthopaedic ◽

Hindfoot Arthrodesis ◽

Old Females

Category: Midfoot/Forefoot Introduction/Purpose: Müller-Weiss Disease (MWD) is also known as Müller-Weiss Syndrome, which is reported an uncommon adult navicular osteonecrosis, frequently occurring in middle-aged and old females and characterized by compression and fragmentation of the lateral aspect of the navicular bone and progressive malformation. In this study, we report the results of selective midfoot and hindfoot arthrodesis for treating symptomatic MWD. Methods: From January 2006 to December 2011, 28 patients (31 feet) with MWD were treated with selective arthrodesis with tricortical autologous iliac crest block fixated by screws and plate and retrospectively reviewed. These included 24 females and 4 males, with an average age of 53.1 years (31-65 years), and an average symptoms duration of 8.6 years (1.5-13 years). The disease was staged according to Maceira, which included 3 feet in stage II, 15 feet in stage III, 7 feet in stage IV, and 6 feet in stage V. Pre- and postoperative visual analog scale (VAS) score, American Orthopaedic Foot & Ankle Society (AOFAS), radiologic examination, and patients’ satisfaction rate of the surgery were evaluated at an average of 6.6 years (4-12 years) following surgery. Results: Selective arthrodesis according to various symptoms and CT-scan findings related to MWD, 12 feet had talonavicular arthrodesis, 16 feet had talonavicular-cuneiform arthrodesis, and 3 feet had triple arthrodesis. The follow-up visit showed satisfactory outcomes, solid union was achieved in all cases, with average fusion time was 15.2 weeks (12-26 weeks). VAS score reducing from the preoperative 7.8 (7-9) to postoperative 2.3(0-4), whereas the AOFAS score improved from the preoperative 25.4 (19-42) to the postoperative 80.3 (73-88). The patient’s subjective ratings showed excellent results in 8 feet, good results in 18 feet, and fair outcomes in 5 feet. Conclusion: Selective arthrodesis according to various symptoms and CT-scan findings related to MWD, 12 feet had talonavicular arthrodesis, 16 feet had talonavicular-cuneiform arthrodesis, and 3 feet had triple arthrodesis. The follow-up visit showed satisfactory outcomes, solid union was achieved in all cases, with average fusion time was 15.2 weeks (12-26 weeks). VAS score reducing from the preoperative 7.8 (7-9) to postoperative 2.3(0-4), whereas the AOFAS score improved from the preoperative 25.4 (19-42) to the postoperative 80.3 (73-88). The patient’s subjective ratings showed excellent results in 8 feet, good results in 18 feet, and fair outcomes in 5 feet.

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