Tibiotalocalcaneal Arthrodesis with Intramedullary Fixation

In this paper is described a technique for performing tibiotalocalcaneal arthrodesis using a new type of intramedullary fixation, the ankle fusion nail. This paper also contains a retrospective review of 17 patients with a mean age of 46 years who underwent tibiotalocalcaneal arthrodesis with intramedullary fixation for diagnoses of osteoarthrosis (12 patients), rheumatoid arthritis (4 patients), and destructive distal tibial giant cell tumor (1 patient). With a mean follow-up interval of 22 months, an 82 percent union rate was achieved at a mean time to union of 14 weeks. The authors of this paper describe their technique for accomplishing this form of ankle and hindfoot arthrodesis with an intramedullary ankle fusion nail, and conclude that intramedullary nailing is a solid method of fixation for tibiotalocalcaneal arthrodesis in the appropriately selected patients. The best clinical results (100 percent union rate, 0 percent complication rate) after tibiotalocalcaneal arthrodesis with intramedullary fixation have been obtained in nonneuropathic patients undergoing their first fusion procedure for diagnoses of primary osteoarthrosis or rheumatoid arthritis.