Repair of malunions after ankle arthrodesis

Ankle arthrodesis is an operation that produces fusion of the talocrural joint. Ideally, the ankle is fused in a position of slight valgus, neutral dorsiflexion, midsagittal translation, slight posterior translation, symmetric external rotation, and plantigrade foot alignment. Malunion after ankle arthrodesis is characterized as a deviation from this ideal position. The derangement may produce inefficient or painful gait and pain or dysfunction at the hip, knee, or foot. Preoperative planning is essential to achieve a final plantigrade foot position. Correction is accomplished through the ankle arthrodesis itself, the foot, or the supramalleolar tibia. Complications of ankle malunion repair include nonunion; malunion; nerve, vessel or tendon injury; and infection.