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Arthrodèse tibiotalocalcanéenne par enclouage transplantaire rétrograde en milieu septique : note technique ; à propos de six cas

Tibiotalocalcaneal arthrodesis through retrograde transplantar nailing in a septic environment: a technical note; six case studies

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Médecine et Chirurgie du Pied

Résumé

L’enclouage transplantaire est un bon mode d’ostéosynthèse pour les arthrodèses tibiotalonaviculaires. Cependant, en cas de sepsis actif de l’articulation tibiotarsienne, la mise en place d’un matériel d’ostéosynthèse qui traverse deux articulations, le calcanéus, le talus et pénètre dans la diaphyse tibiale peut faire craindre une extension de l’infection. Cependant, un geste de curetage et de nettoyage radical de l’articulation infectée après prélèvements multiples, un montage rigoureux et stable, une antibiothérapie adaptée permettent non seulement d’obtenir la consolidation osseuse mais également la guérison de l’infection comme le montre cette courte série. Au plan technique, il est nécessaire d’aviver systématiquement l’articulation sous-talienne.

Abstract

Transplantar intramedullary nailing is a good osteosynthesis to stabilize a tibio-talo-navicular arthrodesis. Nevertheless, in the case of infected ankle joint, a hardware material going from calcaneus until tibia diaphysis through two joints may facilitate a spreading of the infection. A good cleaning and curettage of the infected joint after several bacteriological samplings, a stable osteosynthesis, and a specific antibiotherapy can lead to a fusion of the bone and a healing of the infection as demonstrated by this short series. On a technical point of view, it seems necessary to systematically make a curettage of the subtalar joint.

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Références

  1. Goldberg A, Mac Grego A, Dawson J, et al (2012) The demand incidence of symptomatic ankle osteoarthritis presenting to foot & ankle surgeons in the United Kingdom. Foot 22:163–6

    Article  Google Scholar 

  2. Adams JC (1948) Arthrodesis of the ankle joint: experiences with the transfibular approach. J Bone Joint Surg Br 30B:506–11

    CAS  PubMed  Google Scholar 

  3. Kuntscher G (1967) Combined arthrodesis of the ankle and subtalar joints. In: Trans RH, Thomas CC (eds) Practice of intramedullary nailing. Springfield, IL, pp 207–9

    Google Scholar 

  4. Kile TA, Donnely RE, Gehrke JC (1994) Tibiotalocalcaneal arthrodesis with an intramedullary device. Foot Ankle Int 15:669–73

    Article  CAS  PubMed  Google Scholar 

  5. Pinzur MS, Kelikian A (1997) Charcot ankle fusion with a retrograde locked intramedullary nail. Foot Ankle Int 18:699–704

    Article  CAS  PubMed  Google Scholar 

  6. Stone K, Helal B (1991) A method of ankle stabilization. Clin Orthop Relat Res 268:102–6

    Google Scholar 

  7. Jehan S, Shakeel M, Bing AJ, Hill SO (2011) The success of tibiotalocalcaneal arthrodesis with intramedullary nailing — a systematic review of the literature. Acta Orthop Belg 77:644–51

    PubMed  Google Scholar 

  8. Thordarson DB (2004) Fusion in posttraumatic foot and ankle reconstruction. J Am Acad Orthop Surg 12:322–33

    Article  PubMed  Google Scholar 

  9. Kitaoka HB, Romness DW (1992) Arthrodesis for failed ankle arthroplasty. J Arthroplasty 7:277–84

    Article  CAS  PubMed  Google Scholar 

  10. Levine SE, Myerson MS, Lucas P, Sschon LC (1997) Salvage of pseudoarthrosis after tibiotalar arthrodesis. Foot Ankle Int 18:580–5

    Article  CAS  PubMed  Google Scholar 

  11. Klouche S, El-Masri F, Graff W, Mamoudy P (2011) Arthrodesis with Internal Fixation of the Infected Ankle. J Foot Ankle Surg 50:25–30

    Article  PubMed  Google Scholar 

  12. Kappler C, Staubach R, Abdulazim A, et al (2014) Hindfoot arthrodesis for post-infectious ankle destruction using an intramedullary retrograde hindfoot nail. Der Unfallchirurg 117:348–54

    Article  CAS  PubMed  Google Scholar 

  13. Richter D, Hahn MP, Laun RA, et al (1999) Arthrodesis of the Infected Ankle and Subtalar Joint: Technique, Indications, and Results of 45 Consecutive Cases. J Trauma 47:1072–8

    Article  CAS  PubMed  Google Scholar 

  14. Cierny G, Cook WG, Mader JT (1989) Ankle Arthrodesis in the Presence of Ongoing Sepsis. Indications, Methods, and Results. Orthop Clin North Am 20:709–21

    PubMed  Google Scholar 

  15. Moore J, Berberian WS, Lee M (2015) An Analysis of 2 Fusion Methods for the Treatment of Osteomyelitis Following Fractures about the Ankle. Foot Ank Int 36:547–55

    Article  Google Scholar 

  16. Suda AJ, Richter A, Abou-Nouar G, et al (2016) Arthrodesis for Septic Arthritis of the Ankle: Risk Factors and Complications. Arch Orthop Trauma Surg 136:1343–8

    Article  CAS  PubMed  Google Scholar 

  17. Zwipp H, Grass R, Rammelt S, Dahlen C (1999) Arthrodesis -non-union of the ankle. Arthrodesis failed. Chirurg 70:1216–24

    Article  CAS  PubMed  Google Scholar 

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Dumoulin, Q., Zaharia, B., Gavanier, B. et al. Arthrodèse tibiotalocalcanéenne par enclouage transplantaire rétrograde en milieu septique : note technique ; à propos de six cas. Med Chir Pied 33, 30–34 (2017). https://doi.org/10.1007/s10243-017-0458-6

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  • DOI: https://doi.org/10.1007/s10243-017-0458-6

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