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Updated: Jun 26, 2025

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Limb Salvage by Means of Hindfoot Arthrodesis Utilizing Bulk Allograft and External Fixation
Carl Brandon Lindberg1, Rishika Lagisetti1, Amol Saxena1
1Palo Alto Medical Foundation, Santa Cruz, California.
Abstract:
FormatRetrospective Review.Length of follow-up18 months.ClassificationRearfoot and Ankle Reconstruction.MethodologyLevel 4 Retrospective Review.ProceduresA retrospective review was performed of 6 patients who had undergone limb salvage procedures between January 2016 and April 2019. Patients underwent surgery due to severe limb-threatening diagnosis including Charcot and/or osteomyelitis. Salvage arthrodesis was performed with bulk femoral head allograft incorporation using a hexapod external fixation system. The external fixation was retained for an average of 16 weeks. All patients were followed for a postoperative period of 16 months.ResultsSuccessful rearfoot arthrodesis and limb salvage was achieved in ⅚ (83%) of patients.DiscussionThis review demonstrates that limb salvage and arthrodesis are possible using femoral head allograft incorporation by external fixation alone. The involved patients had resolution of the osteomyelitis and Charcot deformity, salvage arthrodesis of the rearfoot and avoidance of a major limb amputation.Levels of Evidence:IV.
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