Tibiotalocalcaneal arthrodesis using a posteriorly angled nail for definitive fixation augmented with fibular onlay graft and autogenous tibial bone graft within the surgical technique of retrograde-delivered locked compression nail: A case series

Abstract

Tibiotalocalaneal arthrodesis has traditionally been reserved for complex hindfoot or ankle pathology with mixed results. Arthrodesis and complication rates vary, and bone grafting is a common adjunct. Evolution of bone graft techniques combined with modernized intramedullary nail designs warrants evaluation. The purpose of this study is to report on clinical outcomes and radiographic union rates of TTCA utilizing a posterior angled IM nail augmented with autogenous bone graft of the tibia combined with a fibular onlay graft. A total of 16 procedures in 16 patients were included. The overall union rate was 100%. The median weeks to radiographic fusion for the ankle joint and subtalar joint was 9 weeks. The authors believe the high union rate is attributable to the combined approach of a posterior angled intramedullary nail augmented with fibular onlay graft and autogenous tibial bone graft harvested with a reamer-irrigator-aspirator system.

Keywords

• Fibular onlay graft
• Intramedullary nail
• Posteriorly angled nail
• Reamer-irrigator-aspiratory system
• Tibiotalocalcaneal arthrodesis