Tibiotalocalcaneal arthrodesis by retrograde intramedullary nailing as a ‘salvage procedure’: clinical, radiographic and baropodometric evaluation of three cases

Abstract

Numerous studies have demonstrated that patients with severe pain and/or hindfoot deformities can be treated successfully with tibiotalar arthrodesis, especially when the motion of the subtalar joint is not compromised. The authors report on a technique known as tibiotalocalcaneal arthrodesis by retrograde intramedullary nailing, and they used it as a ‘salvage procedure’. At the Orthopedic Institute of the University of Ferrara, three patients underwent this process. At a mean follow-up of 2 years and 2 months, they were reviewed: assessment included clinical and radiographic evaluation, as well as gait analysis by electronic baropodometer. Considering both patient satisfaction and objective results, the authors can state that this surgical technique can be regarded as a valid arthrodesis procedure for the ankle in every respect, especially for ‘salvage’ procedures after failed arthrodeses or after non-unions. It can be the first-choice treatment, as it ensures higher biomechanical stability compared with other techniques used previously, thus reducing the risk of failure.