Journal of the American Podiatric Medical Association · 2025
Outcomes of Tibiotalocalcaneal Fusion After Partial Talectomy in the Charcot Ankle.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Quan Shu-Ting, Jiao Wei-Wei, Xu Fang, Sun Lin, Qi Hui, Shen Adong
Аннотация
BACKGROUND: Whether a sequela of neuropathy or a result of infectious processes to dysvascular changes, talar degeneration in the Charcot ankle proves difficult to treat. Total resection followed by bone void filler or grafts is costly, with varying levels of success. Although tibiocalcaneal fusion allows stabilization, this approach remains a procedure of last resort before amputation. This series presents outcomes of partial talectomy with tibiotalocalcaneal arthrodesis.
METHODS: Nineteen patients with Charcot's neuroarthropathy necessitating a tibiotalocalcaneal fusion were included in this study. Tibiotalocalcaneal arthrodesis was performed using a partial talectomy with a combination of internal with and without external fixation constructs.
RESULTS: Among this cohort of 19 patients followed up for a mean ± SD of 22.0 ± 14.8 months, 21% had osteomyelitis of the talus, and 32% presented with a wound at the time of surgery. Successful primary tibiotalocalcaneal arthrodesis with a partial talectomy was reached in 79% of patients. Of patients necessitating revision, two continued with a tibiotalocalcaneal arthrodesis, and the remaining two reverted to a tibiocalcaneal arthrodesis. No patients experienced a major amputation.
CONCLUSIONS: Unstable ankle Charcot's deformity with osseous degeneration poses a serious threat of limb loss without surgical reconstruction. Total talectomy allows complete resection of nonviable bone; however, this irreversible approach removes possibly viable native tissue. Partial talectomy proves an effective option by minimizing osseous resection, allowing primary arthrodesis between autogenous osseous segments. Moreover, in patients with failed partial talectomy, conversion to tibiocalcaneal arthrodesis proved viable. Before total removal of native bone, partial talectomy should be considered.
METHODS: Nineteen patients with Charcot's neuroarthropathy necessitating a tibiotalocalcaneal fusion were included in this study. Tibiotalocalcaneal arthrodesis was performed using a partial talectomy with a combination of internal with and without external fixation constructs.
RESULTS: Among this cohort of 19 patients followed up for a mean ± SD of 22.0 ± 14.8 months, 21% had osteomyelitis of the talus, and 32% presented with a wound at the time of surgery. Successful primary tibiotalocalcaneal arthrodesis with a partial talectomy was reached in 79% of patients. Of patients necessitating revision, two continued with a tibiotalocalcaneal arthrodesis, and the remaining two reverted to a tibiocalcaneal arthrodesis. No patients experienced a major amputation.
CONCLUSIONS: Unstable ankle Charcot's deformity with osseous degeneration poses a serious threat of limb loss without surgical reconstruction. Total talectomy allows complete resection of nonviable bone; however, this irreversible approach removes possibly viable native tissue. Partial talectomy proves an effective option by minimizing osseous resection, allowing primary arthrodesis between autogenous osseous segments. Moreover, in patients with failed partial talectomy, conversion to tibiocalcaneal arthrodesis proved viable. Before total removal of native bone, partial talectomy should be considered.