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Septic History Limits the Outcome of Tibiotalocalcaneal Arthrodesis

Title: Septic History Limits the Outcome of Tibiotalocalcaneal Arthrodesis
Authors: Magalie Meinert; Christian Colcuc; Eva Herrmann; Johannes Harbering; Yves Gramlich; Marc Blank; Reinhard Hoffmann; Sebastian Fischer
Source: Journal of Clinical Medicine, Vol 12, Iss 10, p 3422 (2023)
Publisher Information: MDPI AG
Publication Year: 2023
Collection: Directory of Open Access Journals: DOAJ Articles
Subject Terms: ankle arthrodesis; tibiotalocalcaneal arthrodesis; septic history; hindfoot fusion nail; posttraumatic septic osteoarthritis; Medicine
Description: Joint destruction necessitates tibiotalocalcaneal arthrodesis (TTCA) in cases of clinical deficits that cannot be controlled conservatively, possibly leading to sepsis. We aimed to compare the underlying etiology of posttraumatic joint destruction and the outcomes after TTCA in patients with a septic or aseptic history. Between 2010 and 2022, 216 patients with TTCA were retrospectively enrolled (septic TTCA (S-TTCA) = 129; aseptic TTCA (A-TTCA) = 87). Patient demographics, etiology, Olerud and Molander Ankle Scores (OMASs), Foot Function Index (FFI-D) scores, and Short Form-12 Questionnaire (SF-12) scores were recorded. The mean follow-up period was 6.5 years. Tibial plafond and ankle fractures were the most common causes of sepsis. The mean OMAS was 43.0; the mean FFI-D was 76.7; and the mean SF-12 physical component summary score was 35.5. All the scores differed significantly between the groups ( p < 0.001). With an average of 11 operations until the arthrodesis was achieved, the S-TTCA patients underwent about three times as many operations as the A-TTCA patients ( p < 0.001), and 41% of S-TTCA patients remained permanently unable to work ( p < 0.001). The significantly worse results of S-TTCA compared to A-TTCA show the long and stressful ordeal that patients with a septic history suffer. Further attention must be paid to infection prophylaxis and, if necessary, early infection revision.
Document Type: article in journal/newspaper
Language: English
Relation: https://www.mdpi.com/2077-0383/12/10/3422; https://doaj.org/toc/2077-0383; https://doaj.org/article/cfb23ecaaaf9426498572aa83dc70b5c
DOI: 10.3390/jcm12103422
Availability: https://doi.org/10.3390/jcm12103422; https://doaj.org/article/cfb23ecaaaf9426498572aa83dc70b5c
Accession Number: edsbas.C45CDD5B
Database: BASE