[Combined arthrodesis of tibiotalar and subtalar joints (transtalar approach using a trephine]

The authors describe an original technique of combined tibio-talar and subtalar arthrodesis. They use an anterior approach and remove a bony cylinder, using a trephine driven through the talus and the calcaneus. The cylinder is then replaced upside down, the calcaneal part of the cylinder crossing the subtalar joint. The tibio-talar joint is fixed by two screws. The technique is indicated in cases of talar necrosis with minimal deformity of the foot. It is intended to decrease the incidence of skin necrosis. Four successful cases are reported.