The Chronic Venous Insufficiency represents a common pathological condition, seen in 20-25% of the adult population.
Highlighting the determinants factors and the clinical and imaging aspects of the tibiotarsal ankylosis, complication of chronic venous insufficiency. The influences of this complication on the therapeutic response in leg ulcer.
Patients and methods
We performed a retrospective study on 144 patients with chronic venous insufficiency hospitalized in Dermatology Clinic of Craiova during a year. The diagnosis was established based on history, clinical and paraclinical examination. The data were statistically analyzed using Student t-test. We compared the subgroup of patients presenting tibiotarsal ankylosis with data recorded in patients with chronic venous insufficiency who did not developed this complication.
Our study group included 73 women and 71 men. Patients were aged between 40 and 85 years, with a mean age of 66.6 years in the subgroup of patients with chronic venous insufficiency without tibiotarsal ankylosis and 71.1 years in the subgroup with tibiotarsal ankylosis.
From the group of patients diagnosed in different clinical stages of chronic venous insufficiency 17.36 % presented
tibiotarsal ankylosis, of which 64 % men and 36 % women. Regarding the distribution subgroup of patients with tibiotarsal ankylosis by area of origin, 84% were from rural area and the rest from urban environment. In the subgroup of patients with tibiotarsal ankylosis there were 13 cases with history of post-thrombotic syndrome and 12 patients with history of varicose veins. Comparing with the subgroup of patients without tibiotarsal ankylosis we noticed a higher frequency of decompensation of venous insufficiency based on history of varicose veins of this subset (70.5%). We found correlation between the existence of tibiotarsal ankylosis, long-lasting venous ulcer and its
distal topography. We found no significant correlations (p=0,5) between the presence or absence of ankylosis and
environment provenance or patient’s gender.
• Tibiotarsal ankylosis is correlated with the oldness of CVI and with the absence of measures to prevent venous stasis.
• Tibiotarsal ankylosis is always accompanied by other manifestations of CVI and venous ulcers are old, resistant to treatment, frequently located in distal third of the calf or at foot level.
• Tibiotarsal ankylosis is a complication of neglected CVI and represents an unfavorable risk factor for venous ulcers.