{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:55:44Z","timestamp":1790924144745,"version":"4.1.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"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."],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Tibiotalocalcaneal (TTC) arthrodesis is a common orthopaedic procedure used to manage end-stage pathologies of the ankle and hindfoot. A variety of surgical techniques exist to accomplish TTC arthrodesis. We retrospectively reviewed and compared postoperative outcomes of 2 different TTC arthrodesis constructs, including intramedullary nail (IMN) and open plating (OP) with a plate\/screw construct, in high-risk patients with a wide range of deformity and comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review was conducted on 73 ankles of 69 consecutive patients who underwent TTC arthrodesis by a fellowship-trained foot and ankle orthopaedic surgeon at a tertiary referral academic center between 2014 and 2025. Diagnoses, patient characteristics and comorbidities, postoperative outcomes, and operative data were recorded and evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Postoperative complications occurred in 23 of 73 ankles overall (32%), including 16 of 55 IMN fusions (29%) and 7 of 18 OP fusions (39%) (OR 0.64, 95% CI 0.21-1.96;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.56). Revision TTC arthrodesis was required after 2 of 55 IMN TTC fusions (4%) and 5 of 18 OP TTC fusions (28%) (OR 0.10, 95% CI 0.02-0.56;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.008). IMN revisions were for 2 periprosthetic fractures. OP revisions were for 4 nonunions and 1 periprosthetic fracture. Amputation was performed after 4 IMN fusions (7%) and 1 OP fusion (6%)(OR 1.33, 95% CI 0.14-12.76;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.99). In 19 ankles that presented with nonunion, the salvage TTC arthrodesis was associated with 2 revision TTC fusions (11%), 1 persistent nonunion (5%), and 1 amputation (5%). In 34 ankles that presented with Charcot arthropathy, the salvage TTC arthrodesis was associated with 4 amputations (12%), 2 nonunions (6%), 2 periprosthetic fractures (6%), and 2 revision TTC fusions (6%). Hardware removal was necessary after 13 surgeries (18%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study suggested a lower rate of union and an increased rate of revision surgery after open plating arthrodesis compared with intramedullary nail arthrodesis. Overall, intramedullary nailing may be a more reliable construct compared with open plating in high-risk patients with diabetes and severe deformities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10711007261484160","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T09:35:26Z","timestamp":1790588126000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Tibiotalocalcaneal Arthrodesis: Deformity Correction in Medically Comorbid Patients"],"prefix":"10.1177","author":[{"given":"Austin G.","family":"Alecxih","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina B.","family":"Klouda","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4177-593X","authenticated-orcid":false,"given":"Joseph R.","family":"Duff","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Parker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0728-4718","authenticated-orcid":false,"given":"Andrew W.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse F.","family":"Doty","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Tennessee College of Medicine Chattanooga, Chattanooga, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.jfas.2022.01.003"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/1938640017740674"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-016-4955-4"},{"issue":"5","key":"e_1_3_3_5_2","first-page":"644","article-title":"The success of tibiotalocalcaneal arthrodesis with intramedullary nailing \u2013 a systematic review of the literature","volume":"77","author":"Jehan S","year":"2011","unstructured":"Jehan S, Shakeel M, Bing AJ, Hill SO. The success of tibiotalocalcaneal arthrodesis with intramedullary nailing \u2013 a systematic review of the literature. 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