Abstract
A 38-year-old man was treated for a severely displaced tibiotalar arthrodesis non-union. There was extensive bone loss from the anterior distal tibial plafond, anterior talar subluxation, and varus malalignment. Skin quality along the anteromedial ankle region was poor, with a history of previous wound that had required several months to heal. Using a lateral approach, the tibiotalar non-union was exposed, debrided, reduced, and fixed with a cannulated 90-degree angled blade plate and bone graft. The cannulated feature of the blade plate enabled accurate placement of the blade, with provisional assessment of blade position prior to creating the chisel hole for the blade. The blade plate construct provided rigid internal fixation despite extensive anterior tibial plafond bone deficiency. The medial wound developed postoperative dehiscence that was successfully managed with cephalexin and becaplermin gel dressings. The non-union was healed 5 months after surgery.
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