[Anterograde intramedullary tibio-talo calcaneus arthrodesis (aIMTCA) with spongiosaplasty in pseudarthrosis]

Pseudarthrosis occur in 65% of all ankle joint arthrodesis. From the therapeutical point of view we make a distinction between vital (hypertrophic) and avital (hypotrophic) respectively stable and instable pseudarthrosis. The hypotrophic forms demand an additional cancellous or bone grafting. Especially instable pseudarthrosis have to be treated with a biological osteosynthesis. In the hindfoot the so called compression arthrodesis made one's way. But there is still a discussion about the best method, intern or extern fixation. We report about a case of hypotrophic pseudarthrosis with a mal-position occurring after an ankle joint arthrodesis with a Charnley-Fixateur. A fusion of the ankle joint could be carried out with a proximal respectively anterograde intramedullary nail and allogene cancellous graft.