Tibiocalcaneal fusion for the treatment of talar necrosis

Abstract

Between 1986 and 1996, 21 patients had a tibiocalcanear arthrodesis. Indications for surgery were in all cases either osteomyelitis or avascular necrosis of the talus. External stabilisation was used in 17 patients due to severe soft tissue damage or extensive infection of the talus, internal screw fixation was used in four patients. There were eight complications in seven patients, one patient had a below the knee amputation. The leg length discrepancies after resection of the talus was equalised in four cases with callus distraction using an Ilisarov ring fixator. Follow up evaluation was available in 18 patients after an average of 38 months (12–86 mo.). There were no infectious recurrenies during the follow up period and a solid fusion was achieved in all patients that were followed. According to a modified Kitaoka score, results were excellent and good in 12 of the 18patients. External stabilisation, especially the Ilisarov ring fixator is the primary method of treatment in cases with severe infection or soft tissue damage.