Use of the SIGN IM nail system to stabilize tibiotalocalcaneal arthrodesis in two African hospital settings

OBJECTIVES: To determine the effectiveness and describe the technique of using the Surgical Implant Generation Network (SIGN) nail to augment tibiotalocalcaneal (TTC) arthrodesis in the developing world. DESIGN: Retrospective review of the SIGN database and description of surgical technique. SETTING: Two centers in rural Kenya, East Africa. PATIENTS: Fifty-seven patients with ankle/hindfoot arthritis or severe trauma. We were able to follow 17 through complete arthrodesis. INVENTION: TTC arthrodesis stabilized with SIGN nail. MAIN OUTCOME MEASURE: Radiographic arthrodesis and return to function. RESULT: Of the patients with significant follow-up, arthrodesis occurred in an average of 19.3 ± 7.5 weeks from the date of surgery. CONCLUSIONS: Recognizing the obstacles to follow-up, the SIGN nail placed with the Herzog curve apex posterior is shown to be an effective device to stabilize a TTC arthrodesis in a limited subgroup of patients with full follow-up.