Abstract

ALBERTI, Marisol et al. Versatilidad del clavo endomedular retrógrado largo de tibia para artrodesis tibio-talocalcánea en pacientes con lesiones asociadas en el mismo segmento. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2021, vol.86, n.3, pp.349-355. ISSN 1852-7434.  http://dx.doi.org/https://doi.org/10.15417/issn.1852-7434.2021.86.3.1159.

Background: The joint condition that leads to the need for a tibiocalcaneal arthrodesis may be accompanied by a second injury in the same bone segment, and design nails for arthrodesis are not of adequate length to cover both injuries. We have not found therapeutic options for this type of injury in the literature. Objective: To present a series of cases where a single tibia nail (antegrade placement) was used retrogradely, with the dual objective of performing a tibiotalocalcaneal arthrodesis added to the treatment of an associated injury in the same surgical stage. Materials and methods: We retrospectively evaluated a group of 12 patients who required a tibiotalocalcaneal arthrodesis as well as to simultaneously resolve a local secondary defect from September 2009 to June 2019. The average age was 43.7 (27-61) years, and the global follow-up was 43. 9 months. Results: All patients achieved a tibiocalcaneal arthrodesis confirmed in antero-posterior and lateral radiographs, and 83.3% of the patients recovered their bone stock completely. Conclusion: Faced with the lack of osteosynthesis in the market to resolve associated pathologies in the same patient, we propose the use of a long tibial intramedullary nail placed in a retrograde manner as a treatment option since it has proven to be efficient in achieving tibiocalcaneal arthrodesis. In addition, it could be used as a rail for bone lengthening and transport, and as stabilization to treat simultaneous injuries.

Keywords : Tibiotalocalcaneal arthrodesis; bone lengthening; bone transport; retrograde nail; tibial fracture.

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