Reconstructive Arthrodesis for Advanced Ankle and Subtalar Joint Destruction in Neuropathic and Infected Feet

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00179906%3A_____%2F25%3A10499928" target="_blank" >RIV/00179906:_____/25:10499928 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11150/25:10499928

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=mbNH0fX5yr" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=mbNH0fX5yr</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.3390/jcm14134516" target="_blank" >10.3390/jcm14134516</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Reconstructive Arthrodesis for Advanced Ankle and Subtalar Joint Destruction in Neuropathic and Infected Feet

Popis výsledku v původním jazyce

Background/Objectives: Advanced destruction of the ankle and subtalar joints due to neuropathy, chronic infection, or inflammatory conditions presents a major surgical challenge, often resulting in limb amputation. This descriptive retrospective study aims to evaluate outcomes of reconstructive surgery in patients, in whom limb preservation was prioritized over amputation despite significant soft tissue and osseous involvement. Methods: Between January 2013 and December 2022, 31 reconstructive procedures were performed on 29 patients (16 women and 13 men) with severe hindfoot deformities. Etiologies included Charcot arthropathy (55%), osteomyelitis (25%), combined pathology (10%), and rheumatoid deformity with skin defect (10%). Surgical procedures included tibiotalocalcaneal arthrodesis (39%), astragalectomy with tibiocalcaneal arthrodesis (32%), tibiotalar arthrodesis (23%), and multistage procedures (6%). Fixation methods varied based on the extent of deformity and infection. The union was assessed via radiographs and CT imaging, and outcomes were statistically analyzed using Fisher&apos;s exact test. Results: Successful arthrodesis was achieved in 74% of cases (23/31). The union rate was significantly influenced by the type and level of fixation (p = 0.0199), with the lowest rate observed in tibiotalocalcaneal arthrodesis using external fixation (17%). Complications included surgical site infection or abscess in 42% of cases, requiring reoperation in 35%. Limb amputation was ultimately necessary in five patients (16%). Conclusions: Despite high complication rates, limb-preserving reconstructive surgery remains a viable alternative to amputation in selected high-risk patients with severe hindfoot pathology. Appropriate preoperative planning, tailored surgical strategy, and patient compliance are essential to achieving functional limb salvage and restoring weight-bearing capacity.

Název v anglickém jazyce

Reconstructive Arthrodesis for Advanced Ankle and Subtalar Joint Destruction in Neuropathic and Infected Feet

Popis výsledku anglicky

Background/Objectives: Advanced destruction of the ankle and subtalar joints due to neuropathy, chronic infection, or inflammatory conditions presents a major surgical challenge, often resulting in limb amputation. This descriptive retrospective study aims to evaluate outcomes of reconstructive surgery in patients, in whom limb preservation was prioritized over amputation despite significant soft tissue and osseous involvement. Methods: Between January 2013 and December 2022, 31 reconstructive procedures were performed on 29 patients (16 women and 13 men) with severe hindfoot deformities. Etiologies included Charcot arthropathy (55%), osteomyelitis (25%), combined pathology (10%), and rheumatoid deformity with skin defect (10%). Surgical procedures included tibiotalocalcaneal arthrodesis (39%), astragalectomy with tibiocalcaneal arthrodesis (32%), tibiotalar arthrodesis (23%), and multistage procedures (6%). Fixation methods varied based on the extent of deformity and infection. The union was assessed via radiographs and CT imaging, and outcomes were statistically analyzed using Fisher&apos;s exact test. Results: Successful arthrodesis was achieved in 74% of cases (23/31). The union rate was significantly influenced by the type and level of fixation (p = 0.0199), with the lowest rate observed in tibiotalocalcaneal arthrodesis using external fixation (17%). Complications included surgical site infection or abscess in 42% of cases, requiring reoperation in 35%. Limb amputation was ultimately necessary in five patients (16%). Conclusions: Despite high complication rates, limb-preserving reconstructive surgery remains a viable alternative to amputation in selected high-risk patients with severe hindfoot pathology. Appropriate preoperative planning, tailored surgical strategy, and patient compliance are essential to achieving functional limb salvage and restoring weight-bearing capacity.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30211 - Orthopaedics

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Journal of Clinical Medicine

ISSN

2077-0383

e-ISSN

2077-0383

Svazek periodika

14

Číslo periodika v rámci svazku

13

Stát vydavatele periodika

CH - Švýcarská konfederace

Počet stran výsledku

13

Strana od-do

4516

Kód UT WoS článku

001526116100001

EID výsledku v databázi Scopus

2-s2.0-105019527194