Revision surgeries following ankle arthrodesis fixed with retrograde intramedullary nails affected by mechanical complications

Konstantin A. Grazhdanov; Гражданов Константин Александрович; Pavel P. Zuev; Зуев Павел Павлович; Oleg A. Kauts; Кауц Олег Андреевич; Andrey V. Baratov; Баратов Андрей Владимирович; Igor A. Norkin; Норкин Игорь Алексеевич

doi:10.17816/vto501806

Revision surgeries following ankle arthrodesis fixed with retrograde intramedullary nails affected by mechanical complications

作者: Grazhdanov K.A.¹, Zuev P.P.¹, Kauts O.A.¹, Baratov A.V.¹, Norkin I.A.¹
隶属关系:
1. Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery, V.I. Razumovsky Saratov State Medical University
期: 卷 30, 编号 4 (2023)
页面: 481-490
栏目: Clinical case reports
URL: https://bakhtiniada.ru/0869-8678/article/view/254217
DOI: https://doi.org/10.17816/vto501806
ID: 254217

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BACKGROUND: 25 percent of all musculoskeletal diseases that involve joints of the lower extremities accrues to ankle arthrosis. Late stages of this disease are indications for ankle arthrodesis. To date, surgeons who perform ankle arthrodesis do not agree about both the treatment technique for ankle articular surfaces and the method of their fixation, but other studies and our own observations suggest that 8 to 20 percent of the surgeries performed with retrograde locking rods lead to revision interventions due to the disorder of ankle ankylosis formation caused by mechanical complications associated with the implanted fixators (aseptic loosening of their parts, stress fracture of the intramedullary nail or locking screws, peri-implant tibia fracture).

CLINICAL CASES DESCRIPTION: The aim of this work was to study and demonstrate the results of revision surgical interventions performed for failed ankylosis after ankle arthrodesis with intramedullary rod fixation against the development of mechanical complications. Clinical observations of revision interventions for failed ankylosis of the ankle joint against the complications due to mechanical origin using a retrograde blockable intramedullary rod as the primary fixator were carried out. Our work presents the technology of revision surgical interventions in case of compromised processes of ankle joint bone block formation associated with aseptic loosening of the structural elements, stress fracture of the intramedullary rod and blocking screws, tibial peri-implant fracture.

CONCLUSION: Revision surgery for complications due to mechanical origin after ankle arthrodesis with intramedullary rod fixation requires an individual approach in each clinical case.

关键词

revision arthrodesis, ankle joint, bone defect, intramedullary nail, case report

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MD, Dr. Sci. (Med.), Professor

俄罗斯联邦, Saratov

参考

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2. Fig. 1. Radiographs of patient E.: a — 9 months after her first surgery, b — the revision surgery, and c — 6 months after the revision surgery

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3. Fig. 2. Radiographs of patient Ya.: a — 4 months after his first surgery, b — the revision surgery, and c — 6 months after the revision surgery

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4. Fig. 3. Radiographs of patient R.: a — 8 months after her first surgery, b — the revision surgery, and c — 6 months after the revision surgery

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5. Fig. 4. Radiographs of patient P.: a — 3 months her first surgery, b — the revision surgery, and c — 12 months after the revision surgery

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