There was significantly better results regarding pain and function in the arthroplasty group at 4 months. At 10 years the results were still not superior for osteosynthesis. A Cox regression analysis regarding sex, age, time to surgery, smoking, osteoporosis, trauma type, preoperative function and choice of skin incision comparing the patients without hip complications at 10 years with the patients with failures in each group revealed no risk factor for failure.
25 RA patients with their ankles fused with an intramedullary nail were compared to 35 RA patients with their ankles fused with compression screws. 24/25 nailed patients showed radiographic healing at follow-up after 3 (1–8) years, and 26/35 ankles in the compression screw group examined after 6 (1–14) years healed after the first attempt and another 5 after repeat surgery. In the nailed group 23 patients were satisfied and 2 somewhat satisfied. In the compression screw group 20 were satisfied, 12 somewhat satisfied and 3 dissatisfied. There were 4 deep infections (3 healed after nail extraction and antibiotics, one unhealed) in the nail group and 1 deep infection (healed after antibiotics) in the compression screw group. Six patients in the nailed group also had a permanent plantar sensory loss.
RA patients with a normal subtalar joint are of course only managed by compression screws.