Ankle Height Preservation with the Hind Foot Nail and Iliac Crest Bone Blocks in Patients with Sequelae of Partial or Complete Talus Bone Loss
https://doi.org/10.5704/MOJ.2111.014
- Author:
Gunasekeran C
1
;
Bhowmick K
1
;
Ramasamy B
2
;
Jepegnanam TS
1
Author Information
1. Department of Orthopaedics, Christian Medical College and Hospital Vellore, Vellore, India
2. Department of Orthopaedics, Royal Adelaide Hospital, Adelaide, Australia
- Publication Type:Journal Article
- Keywords:
hind foot arthrodesis, staged management, talar bone loss, infection
- From:Malaysian Orthopaedic Journal
2021;15(No.3):91-98
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The management of talus bone loss in trauma
is difficult and unsatisfactory. This study assessed whether
the height of the ankle was preserved when entire or partial
talar bone loss was managed with hind foot intramedullary
nail augmented with autogenous rectangular or trapezoidal
cortico-cancellous bone blocks from the iliac crest in the
presence of active or latent infection.
Materials and methods: Four patients were included in the
study from January 2011 to December 2017. In the first
stage, all four patients underwent debridement of the ankle,
total or partial excision of the talus, and antibiotic-loaded
bone cement spacer (ALBC) placement in the ankle joint.
The second stage of the arthrodesis procedure was initiated
six to eight weeks after the primary procedure, where these
patients underwent arthrodesis with hindfoot nail and bone
blocks from the iliac crest.
Results: All patients were followed-up for an average of
17.6 months (range 12.0 – 32.0 months). The arthrodesis site
had united in all these four patients. The AOFAS scores were
satisfactory in all patients. One patient underwent nail
removal after the arthrodesis site had united.
Conclusions: The hind foot nail with iliac crest bone block
maintains the ankle height and ensures successful
arthrodesis. In patients with partial/ complete bone loss with
suspicion or confirmation of infection, staging the
arthrodesis procedure minimises the chance of
complications.
- Full text:16.2021my1206.pdf
