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CC BY 4.0 · Rev Bras Ortop (Sao Paulo) 2024; 59(01): e143-e147
DOI: 10.1055/s-0041-1731356
Relato de Caso
Oncologia

Minimally Invasive Tibiotalocalcaneal Arthrodesis with Blocked Retrograde Intramedullary Nail – Report of Three Cases[*]

Article in several languages: português | English
Fernando Delmonte Moreira 
1   Grupo de Cirurgia do Pé e Tornozelo, Serviço de Ortopedia, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil
,
Jorge Eduardo de Schoucair Jambeiro 
1   Grupo de Cirurgia do Pé e Tornozelo, Serviço de Ortopedia, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil
,
Antero Tavares Cordeiro  Neto
1   Grupo de Cirurgia do Pé e Tornozelo, Serviço de Ortopedia, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil
,
José Augusto Oliveira 
1   Grupo de Cirurgia do Pé e Tornozelo, Serviço de Ortopedia, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil
,
Felipe Fernandes Leão 
2   Programa de Residência Médica em Ortopedia e Traumatologia, Serviço de Ortopedia, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil
,
Alex Guedes 
3   Grupo de Oncologia Ortopédica, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brasil
› Author Affiliations Financial Support There was no financial support from public, commercial, or non-profit sources.
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Abstract

Ankle osteoarthritis (AOA) is associated with pain and variable functional limitation, demanding clinical treatment and possible surgical indication when conservative measures are ineffective – arthrodesis has been the procedure of choice, because it reduces pain, restores joint alignment and makes the segment stable, preserving gait. The present study reports 3 cases (3 ankles) of male patients between 49 and 63 years old, with secondary AOA, preoperative American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS AHS) of 27 to 39 points, treated by minimally invasive tibiotalocalcaneal arthrodesis using blocked retrograde intramedullary nail. Hospital stay was of 1 day, and the patients were authorized for immediate loading with removable ambulation orthotics, as tolerated. The physical therapy treatment, introduced since hospitalization, was maintained, prioritizing gait training, strength gain, and proprioception. Clinical and radiographic follow-up was performed at weeks 1, 2, 6, 12 and 24. After evidence of consolidation (between the 6th and 10th weeks), the orthotics were removed. One patient complained of pain in the immediate postoperative period and, at the end of the 1st year, only one patient presented pain during rehabilitation, which was completely resolved with analgesics. Currently, the patients do not present complaints, returning to activities without restrictions – one of them, to the practice of soccer and rappelling. The postoperative AOFAS AHS was from 68 to 86 points.

Keywords

ankle joint - arthrodesis - osteoarthritis - minimally invasive surgical procedures - surgical procedures, operative - ankle

* Work developed in the Groups of Foot and Ankle Surgery and Orthopedic Oncology, Hospital Santa Izabel, Santa Casa de Misericórdia da Bahia, Salvador, BA, Brazil.




Publication History

Received: 22 September 2020

Accepted: 15 January 2021

Article published online:
25 October 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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