Abstract
Tibiotalocalcaneal arthrodesis (TTCA) is a well-established operative procedure for
different severe pathologic conditions of the ankle and hindfoot joints. We present
our results with a modified technique of TTCA using an intramedullary fibular strut
graft in a series of complex cases of patients treated for multiple etiologies shown
to have improved union rates. The technique involves inserting the fibular strut graft
intramedullary after joint preparation and the use of either a Taylor spatial frame
or plate and screws for definitive fixation. We reviewed the records of 16 patients
who had undergone TTCA with this technique at our hospital from September 2013 to
April 2015. Sixteen patients (10 males [62.5%] and 6 females [37.5%]) were included
in the present study. These patients had complex cases and multiple risk factors,
including diabetes, smoking, poor bone stock, and a history of previous surgeries.
The mean follow-up time was 9.1 (range 9 to 18) months. Thirteen patients (81.2%)
subsequently achieved union. The mean visual analog scale scores at the final follow-up
examination had improved from 6.9 to 1.2. We suggest that our technique of TTCA with
intramedullary fibular strut graft with fixation is a reasonable option to salvage
complex cases with risk factors for operative complications.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
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