Tibiotalocalcanean Fusion by Retrograde Sign Nail: An Amazing Solution for Old Ankle Fracture

Background: Old ankle fracture is the most challenging problem in whole over the world. Still it is an unsolved problem in many countries like Bangladesh. For ankle fracture so many under-privileged people in our country usually take traditional treatment in the village and suffer from severe pain during walking. Sometimes they want to commit suicide due to pain. Earlier the tibiotalocalcanean fusion was done by only steinman pin, then by conventional interlocki nail. But retrograde SIGN nail is the amazing solution to relief pain in old ankle fracture. Aim of the study: The aim of this study was to assess the outcomes of tibiotalocalcanean fusion (Arthrodesis) by retrograde SIGN nail. Methods: It was a prospective case series of patients with old ankle fractures treated with the SIGN nail conducted during the period from 2017 to 2019 at NITOR, Dhaka of Bangladesh. A total of 35 patients with old ankle fractures were operated using the SIGN nail among which 29 patients came for follow up at 6, 16 and 18, 48 weeks. So finally 29 patients were finalized as the study population. Result: As per AOFAS score in pre-operative stage, condition of all the participants were ‘poor’ but at post-operative stage AOFAS score was found ‘Excellent’ in 10.34% (n=3), ‘Good’ in 34.48% (n=10) ‘Fair’ in 20.69% (n=6) and ‘Poor’ in 23.48% (n=10) participants respectively. Besides this, according to the VAS score in the pre-operative stage 3.45% mild (n=1), 6.90% moderate (n=2), and 89.65% severe (n=26) cases patients. Besides this, in post-operative stage 48.24% mild (n=14), 44.83% moderate (n=13), and 6.90% severe (n=2) cases. Conclusion: This implant may be a good alternative in developing countries. The findings of this study may be helpful in further similar studies and in the treatment procedure.