Prognostic risk factors for complications associated with tibiotalocalcaneal arthrodesis with a nail

Tibiotalocalcaneal (TTC) arthrodesis with a nail can be an effective salvage procedure for several foot and ankle pathologies, but has a relatively high complication rate. The purpose of this study is to investigate risk factors associated with complications after TTC arthrodesis with a nail.Clinical and radiographic outcomes for 82 patients from 2012 to 2016 who underwent TTC arthrodesis with a nail were retrospectivelyevaluated to determine if patient or surgeon specific variables offered prognostic value in predicting negative outcomes.Diabetes, diabetic neuropathy, high (2) American Society of Anesthesiologists (ASA) classification, and Charcot neuroarthropathy all were predictive of developing a nonunion in either the subtalar ortibiotalar joints (p0.05). Diabetic neuropathy was predictive ofreoperation, and along with HbA1C7.5 was also predictive of hardwarefailure. The odds ratio (OR) for diabetic neuropathy was 2.99 (p0.05)for nonunion in the tibiotalar or subtalar joints, 3.46 (p0.05) for reoperation,and 4.11 (p0.05) for hardware failure. High ASAclassification had an odds ratio of 3.93 (p0.05) for nonunion in the tibiotalar or subtalar joints as well. Diabetes had an odds ratio of 2.57 (p0.05) for nonunion.Patients with diabetic neuropathy, Charcot neuroarthropathy, elevated HbA1C, and ASA classification2 demonstrated a higher complication rate in patients undergoing TTC arthrodesis with a nail.