Letter to the editor regarding ‘Ankle arthrodesis with a fibular bone autograft and intramedullary nail stabilization in post-traumatic loss of the talus. A case report’

Dear Editor,I’ve read with interest doctor Osuch’s report on the successful treatment of the sequel of talar extrusion [1]. The Authors should be commended for their successful reconstruction in such a complicated case.This report also clearly demonstrates the shortcomings of our terminology for hin...

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Bibliographic Details
Main Author: Andrzej Boszczyk
Format: Article
Language:English
Published: Polish Society of Orthopaedics and Traumatology (PTOiTr) 2024-12-01
Series:Chirurgia Narządów Ruchu i Ortopedia Polska
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Online Access:http://polishorthopaedics.pl/gicid/01.3001.0054.8668
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Summary:Dear Editor,I’ve read with interest doctor Osuch’s report on the successful treatment of the sequel of talar extrusion [1]. The Authors should be commended for their successful reconstruction in such a complicated case.This report also clearly demonstrates the shortcomings of our terminology for hindfoot fusions. This is exemplified by the ICD-9 classification, which arbitrarily recognizes only three types of hindfoot fusions (i.e., 81.11 – ankle, 81.12 – triple, and 81.13 – subtalar) with a broad category of 81.17 – others.The presented athrodesis falls into category of tibio-talo-calcaneo-navicular (pantalar) arthrodesis or fusions. With the talus missing, the optimal wording would probably be tibio-calcaneo-navicular fusion, which the Authors have used in the text but not in the title.While a semantic discussion may seem trivial, in my experience, this distinction has clinical significance. Some centers prefer to perform hindfoot nailing in the setting of ankle (Polish: staw skokowo-goleniowy) arthritis. It should be emphasized, that the ankle arthrodesis or fusion (in Polish: artrodeza skokowo-goleniowa) is not achieved by hindfoot nailing. Hindfoot nailing produces tibio-talo-calcaneal fusion. This is of paramount importance to our patients: unlike ankle fusion, tibio-talo-calcaneal fusion prohibits compensatory subtalar movement. These two differ significantly in terms of gait disturbance and energy consumption.Congratulations again on the successful reconstruction of the limb-threatening condition. However, the report’s title may be misleading to some readers.
ISSN:0009-479X
2956-4719