scholarly journals Prognostic risk factors for complications associated with Tibiotalocalcaneal fusion with a nail

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0018
Author(s):  
Ryan Callahan ◽  
Michael Aynardi ◽  
Kempland Walley ◽  
Kaitlin Saloky ◽  
Paul Juiano

Category: Ankle Introduction/Purpose: Tibiotalocalcaneal (TTC) fusion with a nail is an effective salvage procedure for several foot and ankle pathologies, but it is associated with a relatively high complication rate and often performed on patients with multiple medical comorbidities. There is a paucity of literature that aids in predicting outcomes for patients undergoing TTC fusion with a nail. Methods: Clinical and radiographic outcomes for 82 patients from 2012-2016 who underwent TTC fusion with intramedullary nailing were retrospectively evaluated. Postoperative complications of nonunion, infection, reoperation, and hardware failure were included for comparison. Patient dependent variables and surgeon dependent variables were evaluated for association with these postoperative complications. Results: The overall complication rate for TTC fusion with a nail was 47/82 (57.3%). Diabetes (p=.049), diabetic neuropathy (p=.031), ASA classification (p=.005), and Charcot neuropathy (p=.003) were associated with nonunion of either the tibiotalar or subtalar joints in 29/82 (35.3%) patients. Diabetic neuropathy was associated with need for reoperation (p=.016) in 21/82 (25.6%) patients. Diabetic neuropathy (p=.022) and HbA1C >7.5 (p=.047) was associated with hardware failure in 13/82 (15.9%) patients. The odds ratio (OR) for diabetic neuropathy was 2.99 (p=0.038) for nonunion in the tibiotalar or subtalar joints, 3.46 (p=0.021) for re-operation, and 4.11 (p=0.035) for hardware failure. High ASA classification had an odds ratio of 3.93 (p=0.006) for nonunion in the tibiotalar or subtalar joints. Conclusion: Patients with diabetic neuropathy, Charcot neuropathy, elevated HbA1C, and higher ASA classification demonstrated a higher complication rate in patients undergoing TTC fusion with a nail.

Author(s):  
Herman Romero Ramírez ◽  
Norma Muñoz Albán ◽  
Consuelo Albán Meneses ◽  
Alicia Escobar Torres

The article´s goal isto determine if socioeconomic factors influence the postoperative complications of cholecystectomy. For this, the observational study was defined, analytical and quantitative study was conducted in 100 patients who underwent cholecystectomy. A logistic regression model was applied in which risk factors, socioeconomic characteristics, along with a control variable, were incorporated as variables. Three models were run with alternative dependent variables that are delimited by the type of postoperative complication recorded. The results found showed that women show a higher risk of presenting complications after cholecystectomy, the same occurs in older patients. Likewise, the risk is much lower in people with higher education levels and in patients who underwent laparoscopic cholecystectomy, they only have a 5% risk of presenting complications. Postoperative complications after cholecystectomy are minimized by using the laparoscopic technique and socioeconomic factors would influence the risk of suffering postoperative complications after said surgery, which makes laparoscopic cholecystectomy a safe operation with many other benefits and advantages over traditional or conventional surgery.


Author(s):  
Justyna Jończyk ◽  
Jerzy Jankau

AbstractThe presence of postoperative complications may have a significant impact on the outcome of the breast reconstruction. The aim of this study was to investigate early postoperative complications and the risk factors for their occurrence. A prospective analysis was carried out to evaluate surgical outcomes after breast reconstructive surgeries performed over a 2-year period. Procedures included expander/implant (TE/IMP), pedicle transverse rectus abdominis musculocutaneous (pTRAM), and latissimus dorsi (LD) techniques. All adverse events which occurred within 6 weeks of surgery were ranked according to severity based on the contracted Accordion grading system. Outcomes were assessed for their association with surgical, demographic, and clinical variables. Sixty-one consecutive breast reconstruction procedures were analyzed. The overall complication rate was 60.7% (n = 37), and 8 patients (13.1%) required reoperation. The lowest complication rate was observed in implant-based reconstructions (TE/IMP, 18.8%; pTRAM, 72.7%; LD, 78.3%; p = 0.008). Mild complications occurred significantly more often after LD reconstructions (LD, 60.9%; pTRAM, 22.7%; TE/IMP, 12.5%; p = 0.031), while severe complications were significantly more frequent after the pTRAM procedures (pTRAM, 27.3%; TE/IMP, 6.2%; LD, 8.7%; p = 0.047). Severe complications were associated with higher rehospitalization rate (p = 0.010) and longer hospital stay. Study revealed a significant impact of the operative method on the incidence and severity of early complications after breast reconstruction procedures with little effect from other demographic and clinical factors.


BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masakatsu Paku ◽  
Mamoru Uemura ◽  
Masatoshi Kitakaze ◽  
Shiki Fujino ◽  
Takayuki Ogino ◽  
...  

Abstract Background Local recurrence is common after curative resections for rectal cancer. Surgical intervention is among the best treatment choices. However, achieving a negative resection margin often requires extensive pelvic organ resections; thus, the postoperative complication rate is quite high. Recent studies have reported that the inflammatory index could predict postoperative complications. This study aimed to validate the correlation between clinical factors, including inflammatory markers, and severe complications after surgery for local recurrent rectal cancer. Methods This retrospective study included 99 patients that underwent radical resections for local recurrences of rectal cancer. Postoperative complications were graded according to the Clavien-Dindo classification. Grades ≥3 were defined as severe complications. Risk factors for severe complications were identified with univariate and multivariate logistic regression models and assessed with receiver-operating characteristic curves. Results Severe postoperative complications occurred in 38 patients (38.4%). Analyses of correlations between inflammatory markers and severe postoperative complications revealed that the strongest correlation was found between the prognostic nutrition index and severe postoperative complications. The receiver-operating characteristic analysis showed that the optimal prognostic nutrition index cut-off value was 42.2 (sensitivity: 0.790, specificity: 0.508). In univariate and multivariate analyses, a prognostic nutrition index ≤44.2 (Odds ratio: 3.007, 95%CI:1.171–8.255, p = 0.02) and a blood loss ≥2850 mL (Odds ratio: 2.545, 95%CI: 1.044–6.367, p = 0.04) were associated with a significantly higher incidence of severe postoperative complications. Conclusions We found that a low preoperative prognostic nutrition index and excessive intraoperative blood loss were risk factors for severe complications after surgery for local recurrent rectal cancer.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
G Dhanjal ◽  
M Ghouri ◽  
S Crank

Abstract Introduction A significant aspect of Oral and Maxillofacial Surgery workload relates to trauma, particularly soft-tissue injuries. Contingent on the aetiology of injury, facial wounds require debridement and rapid closure to reduce risk of infection and degree of scarring. The aim was to identify possible risks and frequency of postoperative complications, including problems identified by patients following treatment of facial injuries by the Maxillofacial on-call team. Method Data was retrospectively collected from patients who sustained soft-tissue facial injuries treated by the Maxillofacial team and provided with follow-up appointments from January to August 2020. Computerised clinical notes were accessed to determine patient demographics, mechanism and site of injury, location and time of repair, operator grade and postoperative complications (if any). Results 153 patients required debridement and suturing of a facial injury under local or general anaesthetic. Among these, the male to female ratio was 65:35. 47% of facial injuries resulted from mechanical fall. Lips were found to be the most common site (31%) of injury. Postoperative complication rate was 8% within the 8-month period, with reports of infection, wound dehiscence and haematoma requiring further treatment. 58% of complications resulted from treatment carried out between 5pm-5am with a sole operator (DCT/SHO). 83% of complications followed treatment carried out within the Emergency Department rather than Maxillofacial clinical setting. Conclusion Following facial injury repair, just less than 8% of patients experienced complications, which required corrective treatment. Although facial injuries require immediate care, careful planning and performing treatment in a specialised setup may improve perioperative care, thus clinical outcomes.


2021 ◽  
Author(s):  
Alice Laudisio ◽  
Antonio Nenna ◽  
Marta Musarò ◽  
Silvia Angeletti ◽  
Francesco Nappi ◽  
...  

Objective: Procalcitonin (PCT) has been associated with adverse outcomes after cardiac surgery. Nevertheless, there is no consensus on thresholds and timing of PCT measurement to predict adverse outcomes. Materials & methods: A total of 960 patients undergoing elective cardiac surgery were retrospectively evaluated. PCT levels were measured from the first to the seventh postoperative day (POD). The onset of complications was recorded. Results: Complications occurred in 421 (44%) patients. PCT on the third POD was associated with the occurrence of any kind of complications (odds ratio: 1.06; p: 0.037), and noninfectious complications (odds ratio: 1.05; p: 0.035), after adjusting. PCT above the median value at the third POD (>0.33 μg/l) predicted postoperative complications (incidence rate ratio: 1.13; p = 0.035). Conclusion: PCT seems to predict postoperative complications in cardiac surgery. The determination at the third POD yields the greatest sensitivity and specificity.


2003 ◽  
Vol 1 (1) ◽  
pp. 0-0
Author(s):  
Sigitas Tamulis ◽  
Juozas Stanaitis ◽  
Edmundas Gaidamonis ◽  
Raimundas Lunevičius

Sigitas Tamulis, Juozas Stanaitis, Edmundas Gaidamonis, Raimundas LunevičiusVilniaus universiteto, Bendrosios ir kraujagyslių chirurgijos klinikosBendrosios chirurgijos centrasVilniaus universitetinė greitosios pagalbos ligoninė Įvadas / tikslas Įvertinti pooperacinių pilvo sienos išvaržų gydymo naudojant sintetinį tinklą ankstyvuosius ir vėlyvuosius pooperacinius rezultatus ir veiksnius, lemiančius pooperacines komplikacijas bei išvaržos atsinaujinimą. Ligoniai ir metodai Vilniaus greitosios pagalbos universitetinės ligoninės Bendrosios chirurgijos klinikoje, o vėliau – Bendrosios chirurgijos centre 2000–2002 metais nuo pooperacinių pilvo sienos išvaržų operuotas 221 ligonis. Sintetinis tinklas įsiūtas 82 (37 %) atvejais. Ligonių amžius, lytis, buvusios pooperacinės pilvo sienos išvaržos operacijos, išvaržos vartų dydis pagal Stoppa klasifikaciją, tinklo rūšis, įsiuvimo vieta, profilaktinis gydymas antibiotikais, žaizdos drenavimas vertinti kaip veiksniai, lemiantys pooperacinių komplikacijų pasireiškimą ir išvaržos atsinaujinimą. Rezultatai Pooperacinių komplikacijų buvo devyniems ligoniams (11 %), iš jų aštuoniems (9,7 %) nustatytos vietinės žaizdos komplikacijos: žaizdos seroma – penkiems (6,1 %), žaizdos infekcija – dviem (2,4 %), pooperacinis pilvo sienos uždegimas be pūlių sankaupos – vienam (1,2 %). Bendras infekcinių komplikacijų dažnis sudarė 3,6 %. Ligonių, kuriems nustatytos pooperacinės komplikacijos, vidutinis amžius buvo 65,5 metai, t. y. tik trejais metais didesnis už bendrą ligonių amžiaus vidurkį. Santykinai daugiau vietinių komplikacijų pasireiškė ligoniams, kuriems buvo Stoppa III laipsnio pooperacinės išvaržos (16 %, palyginti su 9,7 % bendru komplikacijų dažniu). Profilaktinis gydymas antibiotikais 6,3 % sumažino pooperacinių infekcinių komplikacijų dažnį (taikant šį gydymą – 2,8 %, netaikant – 9,1 %). Įsiuvus proleno tinklą, pooperacinių komplikacijų radosi 5,1 % mažiau negu naudojant mersileno tinklą. Įsiuvimo padėtis įtakos pooperacinių komplikacijų pasireiškimo dažniui neturėjo. Žaizdos drenavimas 7,5 % sumažino vietinių komplikacijų dažnį. Išvaržos atsinaujino 10,9 % ligonių. Jaunesnies kaip 60 metų amžiaus ligoniams recidyvų buvo 4,5 kartus daugiau negu vyresniems. Vyrams išvaržos atsinaujino 2,4 karto dažniau negu moterims. Kartotinių operacijų nuo pooperacinės išvaržos atvejais recidyvų buvo 3,6 % daugiau negu operuojant pirmą kartą. Recidyvų radosi 22,7 % ligoniams, kuriems buvo Stoppa I–II laipsnio išvaržos, ir nė vienam iš ligonių, kuriems buvo Stoppa III–IV laipsnio išvaržos. Išvaržos atsinaujino 18,75 % ligonių, kuriems buvo įsiūtas proleno tinklas, ir tik 6,9 % ligonių, kuriems įsiūtas mersileno tinklas. Antibiotikų profilaktika ir žaizdos drenavimas išvaržos atsinaujinimo dažnį sumažino atitinkamai 25,8 % ir 10,3 % (7,5 % / 33,3 % ir 9,7 % / 20 %). Išvados Darant hernioplastikas aloplastiniu tinklu, pooperacinių pilvo sienos išvaržų dažnis sumažėja keturis kartus. Tinklus įsiuvus preperitoniškai ar po raumenimis („Sublay“ metodika), išvaržų atsinaujinimo dažnis – 11 %. Taikant profilaktinį gydymą antibiotikais, vietinių infekcinių komplikacijų dažnis sumažėja tris kartus, pooperacinių išvaržų atsinaujinimo dažnis – keturis kartus. Tinklo rūšis (prolenas, mersilenas) ankstyvų komplikacijų dažniui įtakos neturėjo. Tinklas turi būti pakankamai platus: jis įsiuvamas iš visų pusių mažiausiai 5 cm plačiau nuo pilvo sienoje susidariusio raumenų ir fascijos defekto. Žaizdos drenavimas turi įtakos tik seromų susidarymui (drenavus jų pasitaiko 3 kartus mažiau); vietinių infekcinių komplikacijų dažniui šis veiksnys poveikio neturi. Pooperacinės išvaržos dažniau atsinaujina vyrams iki 60 metų. Darant mažesnių išvaržų (Stoppa I–II) plastiką sintetiniais tinklais, išvaržų atsinaujinimo dažnis (22,7 %) buvo statistiškai patikimai didesnis (palyginti su Stoppa III–IV laipsnio išvaržomis, kai nenustyta nė vienos atsinaujinusios išvaržos); priežastys nėra iki galo aiškios, tačiau tai gali būti susiję su specifine priežastimi – per mažų tinklų įsiuvimu (tinklo dydis turi tiesioginę įtaką kainai). Prasminiai žodžiai: pooperacinė pilvo sienos išvarža, hernioplastika, alotransplantatai, tinklas, komplikacijos. Incisional ventral hernia repair by alloplastic mesh Sigitas Tamulis, Juozas Stanaitis, Edmundas Gaidamonis, Raimundas Lunevičius Background / objective Factors strongly associated with all types of postoperative complications after implantation of synthetic mesh due to postoperative (incisional) ventral hernia have not yet been determined definitely. Therefore, the aim of this study was to evaluate early results, hernia recurrence rate and the factors that might be associated with early as well as late postoperative complications. Methods There were 221 patients operated on for postoperative abdominal wall hernia in Vilnius University Emergency Hospital during 2000–2002. Synthetic mesh was inserted in 82 (37%) of patients. Age, sex, the size of the hernia according to Stoppa classification, the type of the biomaterial, the position of the mesh, antibiotic prophylaxis, wound drainage were considered as the factors that might influence early postoperative complications and hernia recurrence rate. Results Early postoperative complications were detected in nine patients (11%): wound seromas – in 5 (6.1%), wound infection – in 2 (2.4%), postoperative infiltration without puss collection – in one (1.2%). The overall rate of infectious complications was 3.6%. Relatively more numerous postoperative local wound complications were observed in cases of the Stoppa grade III postoperative hernia (16% versus 9.7%). Antibiotic prophylaxis reduced the postoperative infection complication rate (2.8% with antibiotics versus 9.1% without antibiotics). The postoperative complication rate in cases of Prolene mesh implantation was by 5.1% lower than with Mersilene mesh. Wound drainage reduced the postoperative local wound complication rate by 7.5%. However, no factors were strongly associated with early postoperative complications. Overall hernia recurrence rate was 10.9%. There were 4.5 times more recurrences in patients younger than 60 years. The recurrence rate in male was 2.4 times higher than in female. Recurrent postoperative hernias occurred by 3.6% more frequently than after first time operated incisional hernias. The recurrence rate in cases of Stoppa I–II grade of hernia was 22.7% versus 0 in cases of Stoppa grade III–IV (p < 0.05). The proportion of recurrences in cases of Prolene and Mersilene meshes was 18.75% and 6.9%. Antibiotic prophylaxis and wound drainage obviously reduced the recurrence rate (7.5% versus 33.3%, and 9.7% versus 20%, respectively). Conclusions Employment of alloplastic biomaterials four times reduced the recurrence rate, which after the “Sublay” implantation of mesh was 11%. Antibiotic prophylaxis reduced the rate of postoperative complications three times and the rate of recurrence four times. The type of the biomaterial (Prolene or Mersilene) had no influence on the local postoperative complication rate. The size of mesh must be sufficient to replace the musculoaponeurotic defect and by 5 cm should overlap the musculoaponeurotic tissue. Drainage of the wound prevented seroma formation. Hernia recurrences are more frequent in male population aged under 60 years. The size of hernia was a statistically proven factor associated with a higher recurrence rate. This is probably associated with implatation of too small pieces of Prolene mesh. Keywords: postoperative ventral hernia, hernia repair, synthetic mesh, complications, recurrent hernia.


2020 ◽  
Vol 36 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Jun Woo Bong ◽  
Yong Sik Yoon ◽  
Jong Lyul Lee ◽  
Chan Wook Kim ◽  
In Ja Park ◽  
...  

Purpose: This study aimed to compare the short-term outcomes of the open and laparoscopic approaches to 2-stage restorative proctocolectomy (RPC) for Korean patients with ulcerative colitis (UC).Methods: We retrospectively analyzed the medical records of 73 patients with UC who underwent elective RPC between 2009 and 2016. Patient characteristics, operative details, and postoperative complications within 30 days were compared between the open and laparoscopic groups.Results: There were 26 cases (36%) in the laparoscopic group, which had a lower mean body mass index (P = 0.025), faster mean time to recovery of bowel function (P = 0.004), less intraoperative blood loss (P = 0.004), and less pain on the first and seventh postoperative days (P = 0.029 and P = 0.027, respectively) compared to open group. There were no deaths, and the overall complication rate was 43.8%. There was no between-group difference in the overall complication rate; however, postoperative ileus was more frequent in the open group (27.7% vs. 7.7%, P = 0.043). Current smoking (odds ratio [OR], 44.4; P = 0.003) and open surgery (OR, 5.4; P = 0.014) were the independent risk factors for postoperative complications after RPC.Conclusion: Laparoscopic RPC was associated with acceptable morbidity and faster recovery than the open approach. The laparoscopic approach is a feasible and safe option for surgical treatment for UC in selective cases.


2021 ◽  
pp. 000348942110595
Author(s):  
Parisorn Thepmankorn ◽  
Chris B. Choi ◽  
Sean Z. Haimowitz ◽  
Aksha Parray ◽  
Jordon G. Grube ◽  
...  

Background: To investigate the association between American Society of Anesthesiologists (ASA) physical status classification and rates of postoperative complications in patients undergoing facial fracture repair. Methods: Patients were divided into 2 cohorts based on the ASA classification system: Class I/II and Class III/IV. Chi-square and Fisher’s exact tests were used for univariate analyses. Multivariate logistic regressions were used to assess the independent associations of covariates on postoperative complication rates. Results: A total of 3575 patients who underwent facial fracture repair with known ASA classification were identified. Class III/IV patients had higher rates of deep surgical site infection ( P = .012) as well as bleeding, readmission, reoperation, surgical, medical, and overall postoperative complications ( P < .001). Multivariate regression analysis found that Class III/IV was significantly associated with increased length of stay ( P < .001) and risk of overall complications ( P = .032). Specifically, ASA Class III/IV was associated with increased rates of deep surgical site infection ( P = .049), postoperative bleeding ( P = .036), and failure to wean off ventilator ( P = .027). Conclusions: Higher ASA class is associated with increased length of hospital stay and odds of deep surgical site infection, bleeding, and failure to wean off of ventilator following facial fracture repair. Surgeons should be aware of the increased risk for postoperative complications when performing facial fracture repair in patients with high ASA classification.


2021 ◽  
Vol 8 (31) ◽  
pp. 2900-2905
Author(s):  
Sadhu Nagamuneiah ◽  
Gandikota Venkata Prakash ◽  
Sabitha P ◽  
Karthik Periyasamy ◽  
Sanjay Raj Kumar Reddy Madduri ◽  
...  

BACKGROUND Thyroidectomy is a surgical procedure which is commonly performed by surgeons worldwide, but the outcome and complication rates were mainly dependent on the surgeon’s skill and experience, indication and the extent of surgery and the number of thyroid surgeries performed at that particular centre. The aim of this study was to assess the frequency of the postoperative complications after thyroid surgery in Sri Venkateswara Ramnaraian Ruiya Government General Hospital, Tirupati. METHODS A prospective study conducted on 100 patients with thyroid swelling who attended the Sri Venkateshwara Ramnaraian Ruya Government General Hospital, Tirupati. Patient age, sex, rural/urban origin, history, diagnosis, type of surgery, laboratory investigation such as complete blood, serum calcium, thyroid function test, us culture and sensitivity test in wound infections and indirect laryngoscopy for all pre-operative patients and postoperative voice change patients. Outcomes recorded as a complication of thyroid surgery within one week. RESULTS Totally 100 patients were enrolled in the study. Thyroid enlargement was more common in females (F: M =5.6:1) presenting in 3rd and 4th decades mostly with the mean age and standard deviation were 42.92 years and 13.097 years respectively. Total thyroidectomy was the most common procedure performed (44 %) followed by hemithyroidectomy (31 %), subtotal thyroidectomies (29 %) and near total thyroidectomy (5 %). On histopathological examination most common finding was multinodular goiter (54 %) followed by nodular goiter (33 %) and malignancies (10 %). The overall postoperative complication rate was 47 %. The most common postoperative complications after thyroidectomies were seroma formation in wound complication (27 %), followed by hypocalcemia (11 %), recurrent laryngeal nerve (RLN) injury (3 %), and surgical site infection (2 %). Majority of these complications were found to be associated with total thyroidectomy, female population, and in patients with age more than 30 years. CONCLUSIONS Seroma formation in wound complication is the commonest post thyroidectomy complication. Female gender, old age, and extensive thyroid surgery were associated with increased complication rate. KEYWORDS Post-Operative Complications, Thyroid Surgery


2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0017
Author(s):  
Daniel Corr ◽  
Jared Raikin ◽  
Joseph T. O’Neil ◽  
Steven M. Raikin

Category: Ankle; Hindfoot Introduction/Purpose: Tibiotalocalcaneal (TTC) arthrodesis (fusion) is considered a salvage procedure for patients with severe hindfoot and ankle pathology. Several techniques have been described for TTC fusion, including the use of an intramedullary rod, plate and screw constructs, screws only, and external fixation/frames. Recently, 3D printing technology has allowed for a new technique to treat large hindfoot and ankle osseous defects with a custom three-dimensional (3D) titanium truss implant. These implants are specifically designed based on preoperative patient computed tomography (CT) scans. Early studies have shown promising radiographic and functional results, though these have been limited largely to expert opinions and case reports. The purpose of this study is to evaluate the clinical, radiographic, and functional outcomes of TTC arthrodesis using a custom 3D titanium truss implant. Methods: A retrospective review of patients who have undergone TTC arthrodesis utilizing a custom 3D-printed titanium truss implant (4WEB Medical, Inc., Frisco, TX) with a fellowship-trained orthopaedic foot and ankle surgeon at a single institution was performed. Patients <18 years old, and those undergoing TTC arthrodesis using any other primary method of filling osseous defects (i.e. femoral head allografts, autografts) were excluded. Patient demographics including age, sex, body mass index (BMI), smoking status, laterality of surgery, co-morbidities (diabetes mellitus, rheumatoid arthritis), preoperative diagnosis, previous hindfoot or ankle surgeries, and any postoperative complications were collected. Patients at least one year removed from the procedure were contacted to complete the Foot and Ankle Ability Measure (FAAM) Activities of Daily Living (ADL) subscale, along with the Visual Analog Scale for pain (VAS) and the Short Form-12 questionnaire (SF-12). Postoperative radiographs were reviewed to assess ankle and hindfoot alignment, implant integrity and any osseous abnormalities. Results: Eighteen patients underwent TTC fusion using custom titanium truss implants and were eligible for follow-up and analysis. Average patient age at the time of surgery was 58.7 years, and average BMI was 30.25 kg/m2. Seven patients (38.9%) were either current or former smokers, and 3 patients (16.7%) were diabetic. On average, patient FAAM ADL scores improved from 33.23 preoperatively to 59.56 (p=0.023), while VAS pain scores decreased from 59.07 to 34.22 (p<0.001). SF-12 Mental Health scores increased from 45.45 to 56.42 (p=0.031), while Physical Health scores improved mildly from 28.78 to 31.75 (p=0.110). Two patients (11.1%) had significant postoperative complications; one patient went on to require below knee amputation, and one patient demonstrated incomplete healing with implant loosening at their most recent follow-up. Conclusion: We have shown that custom titanium truss implants are viable and effective for use in TTC fusion. Use of such implants resulted in significant functional improvement among the cohort with low rates of complications and subsequent surgical interventions.


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