Extended Ankle Arthrodesis: Tibiotalocalcaneal and Pantalar

Fig. 3.1

Preoperative radiographs demonstrating ankle and subtalar arthritis with a 20-degree varus ankle deformity

Fig. 3.2

Postoperative radiographs demonstrating a tibiotalocalcaneal fusion with a fusion nail

Case 2

A 62-year-old male with dense bilateral lower extremity neuropathy secondary to Charcot-Marie-Tooth disease presented with ankle and foot deformity after prior pantalar arthrodesis. He presented with a rigid malunion with fixed hindfoot varus and forefoot supination and adduction. Additionally, he had a lateral bony prominence at the base of the fifth metatarsal and nonhealing ulceration. Preoperative radiographs demonstrated a healed malunited pantalar arthrodesis (Figs. 3.3, 3.4, 3.5). He underwent a revision pantalar fusion with corrective multiplanar hindfoot osteotomy performed by excising a laterally based wedge across the subtalar fusion mass and performing an osteotomy through the transverse tarsal fusion mass. Postoperative radiographs are shown (Figs. 3.6, 3.7).

Fig. 3.3

Preoperative lateral radiograph of malunited pantalar fusion

Fig. 3.4

Preoperative foot AP and oblique radiograph of malunited pantalar fusion

Fig. 3.5

Preoperative calcaneal radiograph of malunited pantalar fusion

Fig. 3.6

Postoperative lateral radiograph after revision pantalar fusion

Fig. 3.7

Postoperative ankle AP radiograph after revision pantalar fusion

References

Jehan S, Shakeel M, Bing AJ, Hill SO. The success of tibiotalocalcaneal arthrodesis with intramedullary nailing – a systematic review of the literature. Acta Orthop Belg. 2011;77(5):644–51. Level III.PubMed

Thomas RL, Sathe V, Habib SI. The use of intramedullary nails in tibiotalocalcaneal arthrodesis. J Am Acad Orthop Surg. 2012;20(1):1–7. Level NA.PubMed

Jeng CL, Campbell JT, Tang EY, Cerrato RA, Myerson MS. Tibiotalocalcaneal arthrodesis with bulk femoral head allograft for salvage of large defects in the ankle. Foot Ankle Int. 2013;34(9):1256–66. Level IV.CrossrefPubMed

Kugan R, Aslam N, Bose D, McNally MA. Outcome of arthrodesis of the hindfoot as a salvage procedure for complex ankle pathology using the Ilizarov technique. Bone Joint J. 2013;95-B(3):371–7. Level IV.CrossrefPubMed

Only gold members can continue reading. Log In or Register to continue