• Massimiliano Mosca, Silvio Caravelli, Mario Fuiano, Simone Massimi, Davide Censoni, Alberto Grassi, Emanuele Vocale, Francesco Ceccarelli, and Stefano Zaffagnini.
• II Clinic of Orthopaedics and Traumatology, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy. Electronic address: massimiliano.mosca@ior.it.
• Injury. 2020 Jun 1; 51 (6): 1377-1381.

IntroductionThe 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 Methods8 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.ResultsMean 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.ConclusionsThe 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.Copyright © 2020 Elsevier Ltd. All rights reserved.

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