Retrograde Tibia Intramedullary Nailing in Tibiotalocalcaneal Arthrodesis
Bibliographic record
Abstract
Background: A case series demonstrating the use of a tibia intermedullary nail placed in a retrograde fashion through the calcaneus and talus as a Tibiotalocalcaneal (TTC) arthrodesis salvage technique in three separate patients. Case Presentation: The first case, an 80-year-old female with a previous Total Knee Arthroplasty (TKA) and ipsilateral open tibia shaft fracture developed a septic non-union with hardware failure. Given her multiple comorbidities, she was treated with a long TTC arthrodesis using a retrograde tibial nail to preserve her soft tissue and encourage earlier mobilisation. The second case, was a 55-year-old male with an open right pilon fracture and multiple surgeries due to non-union of his fracture, including failed TTC with hindfoot nail, he was salvaged with a TTC arthrodesis using a long TTC arthrodesis with a retrograde tibial nail. The last patient, a 30-year-old male who fell 25 feet and suffered a right open pilon fracture required multiple surgeries due to septic non-union, and eventually achieved union after a TTC arthrodesis with osteotomy for deformity correction, both of which were stabilized using a retrograde tibial nail. Conclusion: In this case series, the patients underwent revision surgery for non-union using a long TTC arthrodesis construct with a retrograde tibial nail ultimately achieving union. We found that for select patients, a retrograde tibial nail for TTC arthrodesis was a useful option to reduce complications, achieve union, and help to encourage early mobilization and return of function.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".