Tibiotalocalcaneal arthrodesis with combined retrograde intramedullary nail and lateral L-plate

Achieving stable fixation when performing tibiotalocalcaneal or tibiocalcaneal arthrodesis can be challenging. Patients undergoing these procedures often have osteopenia, poor bone stock, fragmentation of the bones of the foot and ankle, joint subluxation, or even dislocation. The author describes a technique of tibiotalocalcaneal arthrodesis with intramedullary nail fixation augmented by lateral plating through the transfibular approach. This can provide excellent exposure of the ankle and subtalar joints, morselized bone for grafting, and better construct stability.