FUNCTIONAL OUTCOME AND COMPLICATION SPECTRUM OF PANTALAR ARTHRODESIS VIA RETROGRADE INTRAMEDULLARY NAIL IN ANKLE INSTABILITY AND ARTHRITIS: A PROSPECTIVE 30 PATIENTS OBSERVATIONAL STUDY

Background:Pantalar arthrodesis is an essential salvage procedure for patients with severe osteoarthritis and persistent ankle instability unresponsive to conservative treatments. The advent of RETROGRADE INTRAMEDULLARY NAIL/Nailing has introduced a fixation method that minimizes soft-tissue damage while providing robust biomechanical stability, particularly in challenging post‑traumatic cases.

Objective:This prospective observational study aimed to evaluate the functional and radiographic outcomes of pantalar arthrodesis using RETROGRADE INTRAMEDULLARY NAIL/Nailing in a cohort of 30 patients with advanced post‑traumatic ankle instability and osteoarthritis. Additionally, we assessed a refined complication profile and compared our findings with contemporary studies.

Methods:Thirty patients (mean age 46.2  10.4 years 60% male) with a history of post‑traumatic osteoarthritis and ankle instability were included, of whom 33.3% had previously undergone open reduction and osteosynthesis. Indications included flail ankle, implant failure of bimalleolar osteosynthesis, neglected flat foot, associated Tatar fractures, and calcaneal fractures resulting in subtalar and talocalcaneal arthritis. Follow-ups were conducted at 4, 12, and 24 weeks postoperatively, with outcomes measured via AOFAS scores, VAS pain scales, and radiographic union assessments.

Results:Significant clinical improvements were observed over time: AOFAS scores increased from 42.5  12.3 preoperatively to 76.3  10.1 at 24 weeks, while VAS scores decreased from 8.1  1.2 to 3.2  0.9. Radiographic union was achieved in 86.7% of cases by 24 weeks (mean union time: 15.8  3.2 weeks). The complication profile was favorable, with only 6 patients (20.0%) experiencing postoperative complications.

Conclusions:Pantalar arthrodesis using RETROGRADE INTRAMEDULLARY NAIL/Nailing provides significant functional and radiographic improvements in a complex post‑traumatic cohort, with outcomes comparable to recent literature. The technique demonstrates a robust safety profile and represents a viable surgical option for managing advanced ankle pathology.