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Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy

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dc.contributor.author Yammine, Kaissar
dc.contributor.author Assi, Chahine
dc.date.accessioned 2019-05-06T10:36:31Z
dc.date.available 2019-05-06T10:36:31Z
dc.date.copyright 2019 en_US
dc.identifier.issn 2309-4990 en_US
dc.identifier.uri http://hdl.handle.net/10725/10555
dc.description.abstract Purpose: Ankle Charcot neuroarthropathy presents a great challenge for treatment. While conservative treatments yield poor results, arthrodesis is considered the treatment of choice for unstable Charcot ankles. There are two methods used for ankle fusion: retrograde intramedullary nail (IMN) and external fixator (EF). Literature reports inconclusive results on which method is better for arthrodesis. Methods: The aim of this meta-analysis is to look for significant difference between the two techniques in terms of fusion rate and complications. Four comparative studies including 117 patients (117 interventions) were located and analyzed. Results: IMN was found to yield double fusion rate than EF (p = 0.2) with 5 weeks less time to heal (p = 0.4). While no significance was noted for revision surgery and amputation rates, EF yielded higher rates of hardware infection (p = 0.01) and wound infection (p = 0.01). The IMN method seems to offer quicker and better fusion rate when compared to EF with significantly lower postoperative infection rates. Conclusion: In the clinical context of high-risk patients such as the diabetic population, IMN technique could be a better option in the case of ulcer-free ankles/feet or in the presence of medial/lateral ulcers. In case of presence of plantar ulcers, EF might be a better choice to avoid the plantar approach for nail insertion. Future research with bigger sample sized and randomized studies are warranted for validation. en_US
dc.language.iso en en_US
dc.title Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy en_US
dc.type Article en_US
dc.description.version Published en_US
dc.title.subtitle a meta-analysis of comparative studies en_US
dc.author.school SOM en_US
dc.author.idnumber 201801808 en_US
dc.author.idnumber 201004807 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Journal of Orthopaedic Surgery en_US
dc.journal.volume 27 en_US
dc.journal.issue 2 en_US
dc.article.pages 1-7 en_US
dc.keywords Ankle arthrodesis en_US
dc.keywords Charcot neuropathy en_US
dc.keywords External fixator en_US
dc.keywords Retrograde intramedullary nail en_US
dc.identifier.doi https://doi.org/10.1177/2309499019836012 en_US
dc.identifier.ctation Yammine, K., & Assi, C. (2019). Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy: A meta-analysis of comparative studies. Journal of Orthopaedic Surgery, 27(2). en_US
dc.author.email kaissar.yammine@lau.edu.lb en_US
dc.author.email chahine.assi@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://journals.sagepub.com/doi/full/10.1177/2309499019836012 en_US
dc.author.affiliation Lebanese American University en_US


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