Table 3: Bivariate analysis in ankle Charcot patients that underwent reconstruction with intramedullary nailing for tibiotalocalcaneal arthrodesis comparing patients with and without intact plantar calcaneal cortices.
|
|
Intact Plantar Calcaneal Cortices (n=24) |
Fractured Plantar Calcaneal Cortices (n=10) |
P-value |
|
Preoperative Factors |
|
||
|
Age |
52.9 ± 14.8 (44.2 - 61.7) |
53.6 ± 8.1 (47 - 57) |
0.8850 |
|
Body Mass Index |
34.8 ± 9.9 (27.1 - 42) |
33.9 ± 3.3 (30.1 - 36.1) |
0.7651 |
|
Glycosylated hemoglobin A1c |
7.7 ± 2.1 (6.3 - 8.9) |
6.7 ± 2.6 (5 - 8) |
0.2963 |
|
Diabetes |
91.7% (22/24) |
90% (9/10) |
1.0000 |
|
Hypertension |
83.3% (20/24) |
70% (7/10) |
0.3942 |
|
Gender Male / Female |
58.3% (14/24) / 41.7% (10/24) |
40% (4/10) / 60% (6/10) |
0.4569 |
|
Renal disease Chronic kidney disease End stage renal disease |
45.8% (11/24) 16.7% (4/24) 29.2% (7/24) |
40% (4/10) 20% (2/10) 20% (2/10)
|
1.0000 1.0000 0.6921 |
|
Peripheral arterial disease |
29.2% (7/24) |
20% (2/10) |
0.6921 |
|
Smoker / smoking history |
16.7% (4/24) |
10% (1/10) |
1.0000 |
|
Intraoperative Factors: Type of Reconstruction |
|
||
|
Tibiotalocalcaneal arthrodesis |
58.3% (14/24) |
80% (8/10) |
0.4322 |
|
Tibiocalcaneal arthrodesis (talectomy) |
33.3% (8/24) |
0% (0/10) |
0.0720 |
|
Ankle arthrodesis |
8.3% (2/24) |
0% (0 /10) |
1.0000 |
|
Pantalar arthrodesis |
0% (0/24) |
20% (2/10) |
0.0802 |
|
Intraoperative Factors: Fixation |
|
||
|
Hybrid Construct |
29.2% (7/24) |
60% (6/10) |
0.1297 |
|
External fixation |
29.2% (7/24) |
60% (6/10) |
0.1297 |
|
Solely internal fixation |
70.8% (17/24) |
40% (4/10) |
0.1297 |
|
Screws/plate |
33.3% (8/24) |
20% (2/10) |
0.6833 |
|
Bone graft |
50% (12/24) |
70% (7/10) |
0.4513 |
|
Postoperative Outcomes |
|
||
|
Osteomyelitis |
33.3% (8/24) |
10% (1/10) |
0.2250 |
|
Surgical site dehiscence |
12.5% (3 /24) |
20% (2/10) |
0.6181 |
|
Surgical site infection |
29.2% (7/24) |
40% (4/10) |
0.6915 |
|
Charcot recurrence |
8.3% (2/24) |
0% (0/10) |
1.0000 |
|
New Charcot collapse |
0% (0/24) |
0% (0/10) |
n/a |
|
Tibial Fracture |
4.2% (1/24) |
0% (0/10) |
1.0000 |
|
Loss of correction / recurrent dislocation |
8.3% (2/24) |
0% (0/10) |
1.0000 |
|
Malunion |
0% (0/24) |
10% (1/10) |
0.2941 |
|
Non-union |
8.3% (2/24) |
10% (1/10) |
1.0000 |
|
Revision fusion |
8.3% (2/24) |
0% (0/10) |
1.0000 |
|
Time to revisional surgery |
346.5 ± 282.1 (147 - 546) |
n/a |
n/a |
|
Time to external fixation removal |
77.2 ± 16.5 (81 - 85) |
105.6 ± 27.8 (85 - 119) |
0.1732 |
|
Wound healed |
58.3% (14/24) |
40% (4/10) |
0.3554 |
|
Time to wound healing (days) |
586.6 ± 829.1 (42 - 1713) |
608.7 ± 704.6 (43 - 1398) |
0.8197 |
|
Recurrent ulceration |
4.2% (1/24) |
20% (2/10) |
0.2005 |
|
New ulceration |
33.3% (8/24) |
20% (2/10) |
0.6833 |
|
Major lower extremity amputation Below the knee amputation Above the knee amputation |
16.7% (4/24) 16.7% (4/24) 0% (0/24) |
10% (1/10) 10% (1/10) 0% (0/10) |
1.0000 1.0000 n/a |
|
Deceased |
16.7% (4/24) |
0% (0/10) |
0.2890 |
|
Time to death |
255.3 ± 269.0 (102 - 408.5) |
n/a |
n/a |
|
Postoperative: Hardware Complications |
|
||
|
Hardware failure |
29.2% (7/24) |
20% (2/10) |
0.6921 |
|
Broken hardware |
20.8% (5/24) |
10% (1/10) |
0.6445 |
|
Removal of internal hardware (screws / plates) |
16.7% (4/24) |
0% (0/10) |
0.5404 |
|
Removal of intramedullary nail |
16.7% (4/24) |
10% (1/10) |
0.6244 |
|
External fixator pin tract infection |
4.2% (1/24) |
10% (1/10) |
1.0000 |
|
External fixator removed early |
12.5% (3/24) |
0% (0/10) |
0.1667 |
|
External fixator removed early secondary to infection |
12.5% (3/24) |
0% (0/10) |
0.1667 |
|
External fixator removed early secondary to hardware failure |
4.2% (1/24) |
0% (0/10) |
1.0000 |