Tibiotalocalcaneal Fusion With Retrograde Locked Intramedullary Nailing

Tibiotalocalcaneal fusion with a locked intramedullary nail is an excellent option to salvage the foot and ankle for patients with severe pathologies of the tibiotalar and subtalar joints with poor bone stock and impaired soft tissue mantle. To overcome some of the pitfalls of this technique, we compiled previous publications on this subject and formulated a method for minimizing the typical problems of this procedure. The important factors to consider are the use of a minimally invasive technique for debridement of the joints, maintaining a sufficient compression and stability at the fusion site, and placing the intramedullary nail correctly.