Ankle arthrodesis

Arthrodesis for severe ankle deformity and instability has traditionally been reported to have a high incidence of non-union and pseudoarthrosis in patients with neuroarthropathy. Recent reports however, are more encouraging, with authors reporting success rates ranging from 66 to 100%. In cases where solid ankle fusion is not achieved, there may still be an acceptable outcome with fibrous ankylosis, when the foot is satisfactorily aligned beneath the leg. Failure to obtain fusion maybe due to postoperative infection, deficiency of the arthrodesis, refracture through the site of fusion or hardware failure. The following case illustrates the surgical treatment for severe destruction and instability of the ankle in a patient whose deformity could not be braced or accommodated in custom footwear.

The surgical procedure was a tibiocalcaneal fusion with autogenous bone graft and intramedullary nailing. The goal of surgery was to realign the calcaneus under the tibia, in a plantigrade weightbearing position.

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