{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:54:15Z","timestamp":1792814055354,"version":"4.5.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2017,10,16]],"date-time":"2017-10-16T00:00:00Z","timestamp":1508112000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foot Ankle Int."],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ankle fusion is difficult to achieve in the diabetic Charcot ankle Brodsky type 3a because of the poor quality of the bone and the inability to achieve a stable biomechanical construct. The aim of this study was to report the outcome of ankle fusion using a combination of an intramedullary nail and a circular external fixator in patients with diabetic Charcot arthropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We prospectively studied 24 patients with diabetic Charcot arthropathy of the ankle who were treated by fusion of the tibiotalar joint using a combined retrograde intramedullary nail and Ilizarov external fixator. Their mean age was 50.7 \u00b1 6.9 (range, 43-62) years. The mean follow-up after surgery was 36.4 \u00b1 5.8 (range, 24-98) months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Twenty-two patients (92%) achieved clinical and radiographic solid bony fusion. No patients in this series needed amputation. All the patients were pain free, and the mean American Orthopaedic Foot &amp; Ankle Society Score (AOFAS) improved significantly from 34.6 \u00b1 6.8 to 66.4 \u00b1 4.5 at the last follow-up. Two patients developed an ulcer over the heel due to a prominent nail. The ulcer healed after nail removal. Eight patients developed pin tract infection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We report a successful outcomes of ankle fusions using combined intramedullary nail locked only proximally and ring external fixator (hybrid fixation) in patients with diabetic Charcot arthropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1071100717735074","type":"journal-article","created":{"date-parts":[[2017,10,16]],"date-time":"2017-10-16T14:20:34Z","timestamp":1508163634000},"page":"93-98","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":39,"title":["Hybrid Fixation for Ankle Fusion in Diabetic Charcot Arthropathy"],"prefix":"10.1177","volume":"39","author":[{"given":"Hani","family":"El-Mowafi","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Eldakahlia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen","family":"Abulsaad","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Eldakahlia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasser","family":"Kandil","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Eldakahlia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"El-Hawary","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Eldakahlia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Faculty of Medicine, Mansoura University, Mansoura, Eldakahlia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,10,16]]},"reference":[{"key":"bibr1-1071100717735074","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B7.20090"},{"key":"bibr2-1071100717735074","first-page":"895","volume-title":"Surgery of the Foot and Ankle","author":"Brodsky 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