One-stage procedure with debridement and arthrodesis using external fixators for the treatment of chronic hindfoot infections: a retrospective study.

BACKGROUND

Chronic hindfoot infections poses a significant threat to limb integrity and quality of life. The one-stage procedure, involving implants removal, debridement, and simultaneous arthrodesis, may serve as an alternative choice. The present retrospective study aimed to assess the efficacy of the one-stage procedure using external fixators for the treatment of chronic hindfoot infections.

METHODS

From April 2016 to December 2022, 21 patients with chronic hindfoot infections underwent one-stage procedure with debridement and arthrodesis using external fixators. Pain and joint function were evaluated using the Visual Analogue Scale (VAS) and American Orthopaedic Foot and Ankle Society (AOFAS) Score. Infection recurrence and osseous consolidation were appraised using the Musculoskeletal Infection Society criteria and radiological examination.

RESULTS

The tibiotalar, tibiotalocalcaneal, and pan-tarsal arthrodesis were performed in 6, 14 and 1 patients, respectively. The surgical debridement procedures were performed using arthroscopic (n = 9) and combined open (n = 12) methods. The mean follow-up duration was 38.2 (range 25-103) months. The procedure achieved significant pain relieve and functional improvement, as evidenced by the substantial improvement in VAS and AOFAS score from 6.4 ± 1.7 and 40.0 ± 11.6 preoperatively to 1.3 ± 1.4 (p < 0.001) and 78.4 ± 10.8 (p < 0.001) postoperatively, respectively. No instance of infection recurrence was observed during follow-up, and successful osseous consolidation was achieved in 20 patients.

CONCLUSIONS

The one-stage procedure with debridement and arthrodesis using external fixators represented an alternative method for the treatment of chronic hindfoot infections.