RETROGRADE INTRAMEDULLARY NAILING FOR ANKLE ARTHRODESIS

This is a retrospective study of retrograde intramedullary redding for ankle arthrodesis in 19 ankles in 16 patients. The preoperative diagn osis of 16 patients was diabetic neuropathic arthropathy in seven pati ents, rheumatoid arthritis in three patients, post traumatic arthrosis in three patients, paraplegia with fixed equinovarus of the foot in t wo patients, and avascular necrosis of the talus in one patient. Retro grade intramedullary redding for ankle arthrodesis was done as a salva ge procedure in each patient. Fourteen of the 19 ankles had radiograph ic evidence of solid arthrodesis. In the four patients with five ankle s with pseudarthrosis, no case was clinically significant. There was o ne deep infection and one broken rod. Thirteen of the 16 patients are ambulatory, and nine required either an ankle-foot orthosis or shoe mo dification. The standard method of ankle fusion using crossed cancello us screws is the procedure of choice because it preserves the subtalar joint. Retrograde intramedullary redding for ankle arthrodesis should be considered for patients with significant posttraumatic arthrosis a nd bone loss following distal tibial plafond fractures, concomitant su btalar arthrosis, severe osteopenia, such as in patients with rheumato id arthritis, or neuropathic arthropathy.