Tibiotalocalcaneal Fusion: Indications and Techniques


Tibiotalocalcaneal fusion is indicated for patients in whom conservative bracing for conditions involving the ankle and subtalar joint has failed. The most common indications for tibiotalocalcaneal fusion are posttraumatic arthritis, in some cases with osteonecrosis of the talus; Charcot arthropathy of the ankle or hindfoot; and failed total ankle replacement. Use of an intramedullary rod in such cases provides strong internal biomechanical fixation with a load-sharing device. This paper describes the surgical technique for tibiotalocalcaneal fusion and discusses a number of factors relevant to this procedure. Most recent studies report success rates of approximately 90% with the use of tibiotalocalcaneal fusion for this complex group of patients.

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