Management of failed total ankle replacement with a retrograde short femoral nail: a case report

Arthrodesis of the ankle joint after failed total ankle replacement using internal fixation with plates and screws is problematic because of the significant bone loss. An external fixator has the disadvantage of prolonged treatment until complete consolidation, frequently complicated by pin track infections. Recently an intramedullary fixation has been described for tibio-talo-calcaneal arthrodesis for posttraumatic osteoarthritis of the ankle joint. We report on the use of this technique plus bone graft in a case of failed total ankle replacement complicated by cystic talus degeneration and a massive bony defect. The advantages include early mobilization and weightbearing provided by the stability of the fixation.