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Published on: January 24, 2018
Tibiotalar nonunion corrected by hindfoot arthrodesis
Eric Giza1, Annahita K Sarcon, Christopher Kreulen
1University of California Davis School of Medicine, UC Davis Department of Orthopaedics, Sacramento, 95817, USA. eric.giza@ucdmc.ucdavis.edu
Foot & Ankle Specialist
|April 20, 2010
Summary
A failed ankle fusion revision using tibiotalocalcaneal (TTC) hindfoot fusion successfully restored function. This complex surgery involved hardware removal, bone grafting, and intramedullary nailing, leading to pain relief and improved mobility.
Area of Science:
- Orthopedic Surgery
- Biomaterials Science
Background:
- Ankle arthrodesis is a surgical procedure to fuse the ankle joint, often performed for severe arthritis.
- Failed ankle fusions can lead to persistent pain, deformity, and functional limitations.
Observation:
- A 65-year-old male presented with pain, swelling, and hindfoot valgus 9 months post-ankle arthrodesis.
- Radiographs and CT scans revealed tibiotalar nonunion, talar body erosion, and severe tibiotalar/subtalar arthritis.
- Intraoperative findings included metallic synovitis and bone defects.
Findings:
- Revision surgery using tibiotalocalcaneal (TTC) hindfoot fusion was performed.
- The procedure utilized a retrograde intramedullary nail, femoral head allograft, and fibular autograft with platelet-rich plasma.
- Successful fusion was confirmed radiographically, allowing weight-bearing at 16 weeks.
Implications:
- TTC hindfoot fusion is a viable option for managing failed ankle arthrodesis with significant deformity and bone loss.
- The use of structural allografts and intramedullary fixation can address complex bone defects and provide stability.
- This approach can lead to significant pain reduction and functional recovery in patients with challenging ankle reconstructions.
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