Tibiotalocalcaneal fusion with bulk femoral head allograft in a patient with a rare, trauma induced, rigid, cavovarus foot deformity

Abstract

Tibiotalocalcaneal (TTC) arthrodesis with bulk femoral head allograft is a commonly performed limb salvage procedure when dealing with complex deformity. However, little has been reported in patients who receive tibiotalocalcaneal arthrodesis with femoral head allografts for a rigid cavovarus foot type. The purpose of this case report was to examine the outcomes of a tibiotalocalcaneal arthrodesis with a femoral head allograft in a diabetic patient with a trauma induced rigid cavovarus deformity who had complete lateral dislocation of the talar body. The secondary purpose was to highlight the preservation of limb length in the surgical extremity when utilizing a tibiotalocalcaneal arthrodesis with femoral head allograft when compared to alternative procedural options for patients with similar deformities. Our patient was a 64-year-old male who underwent a tibiotalocalcaneal arthrodesis with femoral head allograft for a trauma induced rigid cavovarus foot type. Following the procedure, he was transitioned out of a controlled ankle motion (CAM) boot into normal shoe gear at 8 weeks. He achieved radiographic union of all fusion sites. At one year follow up he is in 0/10 pain to the surgical site. In conclusion, utilizing a tibiotalocalcaneal arthrodesis with femoral head allograft proved to be an excellent choice of procedure and we believe this is an appropriate procedural choice for patients who present with this unique and challenging deformity.