Tibiotalocalcaneal Fusion Using the Hindfoot Arthrodesis Nail

Abstract

Level IV, retrospective case series.

Tibiotalocalcaneal arthrodesis with a triple-bend intramedullary nail (A3)—2-year follow-up in 60 patients

“…The 6 (9%) patients that did not complete follow-up (No. 3,4,6,19,27,58) were not the patients with complications except one (No. 6, minor tibial split, see above).…”

“…Screws, plates, external fixators, intramedullary nails, and combinations of different implants have been described [2][3][4][5][11][12][13]. TTCA with intramedullary implants can be performed with retrograde femoral nails or retrograde ankle arthrodesis nails [2][3][4][5][6][7][8]. The first biomechanical studies in the literature investigated first-generation retrograde (femoral) nails without foot and ankle specific locking options [14][15][16][17].…”

“…Typical indications are also failed (corrective) arthrodesis of the ankle and subtalar joints, fused ankle and degeneration of the subtalar joint, failed total ankle replacement with insufficient substance of talar body and/or degeneration of subtalar joint, massive hindfoot instability, and severe pilon fractures [1][2][3][4][5][6][7][9][10][11]. TTCA may be performed with different techniques.…”

“…Tibiotalocalcaneal arthrodesis (TTCA) is a salvage procedure for restoration of a stable and plantigrade foot in deformities at the ankle and/or hindfoot and concomitant degenerative changes at the ankle and subtalar joints [1][2][3][4][5][6][7][8]. Typical indications are also failed (corrective) arthrodesis of the ankle and subtalar joints, fused ankle and degeneration of the subtalar joint, failed total ankle replacement with insufficient substance of talar body and/or degeneration of subtalar joint, massive hindfoot instability, and severe pilon fractures [1][2][3][4][5][6][7][9][10][11].…”

Corrective arthrodeses and osteotomies for post-traumatic hindfoot malalignment: indications, techniques, results

“…In cases of osteomyelitis or septic AVN (type V deformity), aggressive debridement, temporary external fixation, and implantation of local antibiotic beads are carried out to eradicate infection. Fusion is then performed as a staged procedure after the infection has resolved, typically with bone grafting, screws, plates, a retrograde intramedullary nail, or external fixation with a largepin or small-wire frame [7,[30][31][32][33]. In cases of tibiocalcaneal arthrodesis, excessive loss of height can be avoided by corticocanellous bone grafting or by sliding a portion from the anterior tibia distally into the defect (Blair fusion [34]).…”