Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy
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 ext...
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2019
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| Online Access: | http://hdl.handle.net/10725/10555 https://doi.org/10.1177/2309499019836012 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://journals.sagepub.com/doi/full/10.1177/2309499019836012 |
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| _version_ | 1864513486972780544 |
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| author | Yammine, Kaissar |
| author2 | Assi, Chahine |
| author2_role | author |
| author_facet | Yammine, Kaissar Assi, Chahine |
| author_role | author |
| dc.creator.none.fl_str_mv | Yammine, Kaissar Assi, Chahine |
| dc.date.none.fl_str_mv | 2019-05-06T10:36:31Z 2019-05-06T10:36:31Z 2019 2019-05-06 |
| dc.identifier.none.fl_str_mv | 2309-4990 http://hdl.handle.net/10725/10555 https://doi.org/10.1177/2309499019836012 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). http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://journals.sagepub.com/doi/full/10.1177/2309499019836012 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Journal of Orthopaedic Surgery |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy a meta-analysis of comparative studies |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | 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. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_3fd0b3422d270bab2e32b5eeabb64ae2 |
| identifier_str_mv | 2309-4990 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). |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/10555 |
| publishDate | 2019 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathya meta-analysis of comparative studiesYammine, KaissarAssi, ChahinePurpose: 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.PublishedN/A2019-05-06T10:36:31Z2019-05-06T10:36:31Z20192019-05-06Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article2309-4990http://hdl.handle.net/10725/10555https://doi.org/10.1177/2309499019836012Yammine, 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).http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.phphttps://journals.sagepub.com/doi/full/10.1177/2309499019836012enJournal of Orthopaedic Surgeryinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/105552021-03-19T10:45:22Z |
| spellingShingle | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy Yammine, Kaissar |
| status_str | publishedVersion |
| title | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy |
| title_full | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy |
| title_fullStr | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy |
| title_full_unstemmed | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy |
| title_short | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy |
| title_sort | Intramedullary nail versus external fixator for ankle arthrodesis in Charcot neuroarthropathy |
| url | http://hdl.handle.net/10725/10555 https://doi.org/10.1177/2309499019836012 http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php https://journals.sagepub.com/doi/full/10.1177/2309499019836012 |