Functional Outcomes of Tibiotalocalcaneal Arthrodesis using a Retrograde Intramedullary Nail in Charcot Arthropathy of the Ankle Joint

Abstract

Background: A progressive joint condition, Charcot neuroarthropathy (CN) is common in diabetics. This study evaluates tibiotalocalcaneal (TTC) arthrodesis with a retrograde intramedullary nail (IMN) for ankle Charcot neuroarthropathy (CN).

Methods: TTC arthrodesis using retrograde intramedullary nails was performed on 33 Charcot neuroarthropathy patients in this observational study. The AOFAS Ankle-Hindfoot Score measured functional outcomes, while radiographic fusion rates and complications were recorded at 6 weeks, 3 months, 6 months, and 1 year after surgery.

 Results: The mean preoperative AOFAS score was 30.4, which improved to 75.6 at a 1-year follow-up (p < 0.001). Fusion was achieved in 87.9% of patients by 6 months. Complications included superficial infections (6.1%) and nonunion (6.1%). No implant failure or re-ulceration was observed.

Conclusion: TTC arthrodesis using retrograde IMN is an effective and safe surgical option for patients with Charcot neuroarthropathy of the ankle, offering high fusion rates, significant functional improvement, and minimal complications.