Ankle Arthrodesis with Intramedullary Nail in Rheumatoid Arthritis

Abstract

We retrospectively reviewed and functionally assessed 13 patients with rheumatoid arthritis (RA) who had undergone ankle arthrodesis with an intramedullary nail. They were all female and followed for an average of 15 months (six to 39 months). The mean duration of RA was 19 years. We used the intramedullary nail with fins for 10 ankles, the ReVision nail (Smith & Nephew) for two ankles, and the Biomet Ankle Arthrodesis Nail for one ankle. Solid fusion was achieved in 11 out of 13 patients. Mean time to union was 4.2 months. The patients were able to bear weight fully in an average of four weeks after surgery. We believe that the intramedullary nail with fins can increase stability, allowing early weight bearing. To treat rheumatoid severe ankle deformities, partial or all resection of the talus was necessary for the correction of ankle alignment. The ReVision nail or the Ankle Arthrodesis Nail was useful for tibiocalcaneal fusion in such cases.