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 unresp onsive 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 INTRAMED ULLARY NAIL Nailing provides significant functional and radiograph ic improvements in a complex post traumatic cohort, with outcomes comparable to recent literature. The technique