Tibiotalocalcaneal arthrodesis for arthritis and deformity of the hind part of the foot.

Tibiotalocalcaneal Arthrodesis with lateral compression Plate

“…Patients who had a TTC arthrodesis with the Tournier Stabilis © plate had substantially higher functional and lower pain scores than before surgery. The mean time to fusion was six months and the postoperative AOFAS score improved from 41 points pre-operatively to 63 points postoperatively, which are comparable to those observed in other studies (3)(4)(5)(6)8,(15)(16)(17)(18)(19)(20) . We believe that the high union rate was due a precise surgical technique, the enhance compression that the system provides, the use of fibular grafting combined with a strong locking plate construct…”

“…The orthopaedic treatment of ankle and subtalar joint disease for which conservative management has failed includes combined tibiotalocalcaneal (TTC) arthrodesis, fusion of the subtalar joint with replacement of the ankle, or joint distraction of the ankle joint with subtalar joint arthrodesis (1)(2)(3)(4) . TTC arthrodesis was first described in 1906 (reported by Mendicino) (5) and continues to be a powerful option in dealing with complex deformities and revisions surgeries and is currently the standard of care for this condition (5,6) . Obtaining adequate surgical fixation during TTC arthrodesis may improve outcomes, but can be challenging.…”

Biomechanical Comparison of Intramedullary Nail and Blade Plate Fixation for Tibiotalocalcaneal Arthrodesis

“…1,2 Often this combined arthrodesis is the only alternative to amputation in conditions involving both the ankle and subtalar joints resulting from posttraumatic arthritis, inflammatory arthropathy, talar osteonecrosis and collapse, failed ankle arthroplasty, failed ankle arthrodesis, Charcot arthropathy, or rheumatoid arthritis. 3,4 The goal of TTC fusion is to achieve a stable, wellaligned hind foot and ankle that is solidly united and pain-free, and to avoid complications from the procedure. To achieve these goals, numerous techniques have been described, including bone grafts and casting, external fixation, internal fixation using screws with or without a plate, intramedullary nailing, and blade plate fixation.…”

“…To achieve these goals, numerous techniques have been described, including bone grafts and casting, external fixation, internal fixation using screws with or without a plate, intramedullary nailing, and blade plate fixation. 2,[4][5][6] Previously, crossed lag screws and intramedullary nailing were the most widely applied methods of fixation because of the compression obtained across the joint using the crossed lag screws and the load-sharing properties of the nail. Recently, the use of the pediatric or proximal humeral blade plate has become a third alternative for stabilization of the TTC arthrodesis because of its improved control in osteoporotic bone and the avoidance of the plantar insertion site.…”

Ankle arthrodesis in rheumatoid arthritis: 30 cases followed for 5 years

“…Infection was a major problem in this group. Russotti et al (1988) have reported similar problems when using this device.…”