Abstract
This study aimed to evaluate the clinical and radiographic outcomes of tibiotalocalcaneal (TTC) nailing in diabetic patients with Charcot neuropathy and ankle fractures. A total of 84 patients underwent TTC nailing between December 2022 and June 2024. Functional outcomes were assessed using the Foot and Ankle Outcome Score (FAOS). Significant improvement was observed, increasing from a preoperative mean of 19.9 ± 3.81 to 72.6 ± 11.66 at six months postoperatively (p < 0.001). Union was achieved in 75 % of patients, with delayed union in 17.9 % and nonunion in 7.1 %. Postoperative complications included superficial infections (7.1 %) and deep infections (3.6 %). No significant correlations were found between final FAOS scores and patient demographics or diabetes-related factors. TTC nailing is a reliable treatment option for this high-risk population. Clinical trial number: not applicable.