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Introduction: The purpose of this study is to determine the efficacy of tibiotalocalcaneal arthrodesis by reamed intramedullary nail in the management of the distal tibia non-unions, associated with end-stage osteoarthritis of ankle and subtalar joints.Materials and Methods: 8 patients with radiographical and clinical diagnosis of non-union of the distal tibia have been treated with tibiotalocalcaneal arthrodesis by intramedullary retrograde nail and were retrospectively evaluated. Patients were radiographically and clinically evaluated preoperatively and at final follow-up regarding: satisfaction, AOFAS, VAS. Surgical technique is described.Results: Mean follow-up was 69.2 ± 23.2 months (range 48-108). In terms of subjective outcome, patients reported a highly satisfying result. All patients returned to daily activities, with an average time of 24.7 ± 8.7 weeks. 6 patients could return to their previous work activity, with an average time of 23.6 ± 6.3 weeks.Conclusions: The procedure showed good results at final follow up. Consolidation was achieved in all the treated cases. Considering AOFAS and VAS scores at final follow-up, there was an evident improvement of the conditions of the patients. [ABSTRACT FROM AUTHOR]

Background: A new design of 3-part ankle replacement was developed to achieve compatibility with the natural ligaments by allowing certain fibers to remain isometric during passive motion.Methods: We evaluate 75 ankle prostheses implanted from July 2003 to December 2008, at a mean follow-up 6.5±1.1years (range 5-9 years). The mean age at surgery was 62±13years (range 29-82).Results: The mean AOFAS scores achieved at pre-op and at last follow-up were respectively 37±5 (23-45) and 78±8 (64-98). (p<0.001). Clinical range of motion of the ankle measured by goniometer pre op was 1°±2 of dorsiflexion and 12°±4° of plantarflexion; at last follow-up range of motion increased to 6°±5° in dorsiflexion (p<0.01) and 18°±7° in plantarflexion (p<0.05). Radiographs showed no loosening and little signs of radiolucency. Two revisions necessitated component removal, neither for implant loosening. The overall survival rate was 97.3%.Conclusions: Function and Range-of-motion showed significant improvements. These results demonstrate that ligaments-compatible shaped talar and tibial components, with a fully conforming interposed meniscal bearing, can provide satisfactory survival rates and clinical outcomes in the middle term. [ABSTRACT FROM AUTHOR]