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KMID : 1130920170210030098
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Journal of Korean Foot and Ankle Society
2017 Volume.21 No. 3 p.98 ~ p.103
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Analysis about Associated Factors of Nonunion Following Tibiotalar Arthrodesis
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Lee Jun-Young
Kim Bo-Seon
Lee Jung-Woo
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Abstract
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Purpose: The aim of this study was to analyze the factors related to nonunion in tibiotalar arthrodesis.
Materials and Methods: Eighty cases of ankle arthritis treated with tibiotalar arthrodesis in our hospital from November 2008 to November 2015 with more than one year follow up were analyzed. Simple anteroposterior and lateral radiographs after 6 and 12 months of surgery were analyzed. Union was defined as more than 50% connection of the trabecular bone at the ankle joint surface in the anteroposterior and lateral radiographs. The nonunion group was defined as no signs of union with persistent pain 9 months after surgery. The surgical approach, type of used screw, preoperative and postoperative ankle alignment, body mass index (BMI), bone mineral density, and patients’ prior history were compared between the two groups.
Results: There were 69 union cases and 11 nonunion cases. In the patient factors, the gender and BMI was related to nonunion (p<0.05). The mean preoperative and postoperative ankle alignment in the nonunion group was 9.93°±6.92° and 5.43°±3.35° respectively, and 9.80°±7.55° and 5.63°±3.45° in the union group, respectively; the difference was not statistically significant (p>0.05). In the technical factors, the transfibular approach showed a better relationship but the association was not significant (p<0.05). In 40 cases of the transfibular approach, 12 cases used cancellous screws, and 4 cases showed nonunion due to screw breakage.
Conclusion: Technical factors, such as the surgical approach and the type of screw used can be a risk factor in nonunion. In addition, patients’ factors, such as gender and BMI, must be considered to reduce the nonunion rate.
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KEYWORD
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Arthrodesis, Nonunion
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