Minimally Invasive Arthroscopy-Assisted Tibiotalocalcaneal Nailing for Complex Hindfoot Deformities: A Technique Tip

Hindfoot reconstruction is a frequently performed procedure for many complex hindfoot deformities including flatfoot, end-stage arthritis, and Charcot arthropathy. Literature has supported the treatment of these patients with a tibiotalocalcaneal (TTC) arthrodesis. However, this limb salvage procedure is complex in nature and is traditionally performed as an open surgery. Minimally invasive (MIS) tibiotalar and subtalar fusions have allowed for similar efficacy as the open procedure, with the potential for less wound complications. The current study presents a guide for TTC nailing with MIS preparation of the tibiotalar and subtalar joints for severe, progressive hindfoot deformity in the high-risk patient. This technique allows for maintenance of the soft tissue envelope; maintaining the integrity of these structures may help surgeons avoid many wound related complications, infections, or need for revision. This guide provides surgeons with an effective and reproducible approach to intervene in complex cases requiring hindfoot reconstruction.Levels of Evidence: Level V Evidence.