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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Main Author: Yammine, Kaissar (author)
Other Authors: Assi, Chahine (author)
Format: article
Published: 2019
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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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
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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