Tibio-talo-calaneal arthrodesis by retrograde intramedullary nail and bone grafting

Abstract 

Tibio-talo-calcaneal fusion is a salvage procedure for severe ankle and hind foot arthrosis with deformity. There are numerous techniques described in the literature but no uniformly accepted method. We conducted a retrospective study of 40 patients who underwent 43 tibio-talo-calcaneal fusions with a retrograde intramedullary nail and bone grafting. The average age was 52 years. The average follow up was 34 months. Patients were assessed clinically; radio logically, the AOFAS score and patient satisfaction. Solid fusion was achieved in 37 cases. Post-operative AOFAS score showed improvement in pain and function. The procedure was associated with high complications and morbidity including one below knee amputation. We conclude that tibio-talo-calcaneal fusions with retrograde nailing and bone grafting is a successful salvage procedure in these advanced cases to improve pain and function.

Keywords: Arthroses, Deformity, Tibio-talo-calcaneal fusion, Retrograde nail, Salvage procedure