HOT TOPIC: Intramedullary Nail Options for Tibiotalocalcaneal Fusion

Abstract

Tibiotalocalcaneal (TTC) arthrodesis is a salvage procedure for pain and hindfoot deformity related to tibiotalar and subtalar joint disease, failed total ankle replacement, osteonecrosis of the talus, and Charcot neuroarthropathy. A variety of fixation options for TTC arthrodesis are currently available, including locking plates and screws, fixed-angle devices such as blade plates, external fixation devices, and retrograde intramedullary nails. With the evolution of retrograde intramedullary nails designed specifically for TTC arthrodesis, retrograde intramedullary nailing has emerged as a reproducible and reliable means of treating significant hindfoot deformities. This article reviews the surgical technique, nail design considerations, complications, and outcomes related to TTC fusion using a retrograde intramedullary nail.

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