Tibiotalocalcaneal Arthrodesis With Medullary Rod Fixation

Surgical fusion of the ankle and subtalar joints during the same operative procedure is termed tibiotalocalcaneal arthrodesis and it may be used to relieve pain and improve function for patients with the indications of arthritis, avascular necrosis, pseudoarthrosis, neuromuscular disease, and the sequelae of trauma. Medullary nail fixation for this procedure uses a modern approach to an established concept that has the advantages of providing immediate rigid internal fixation with compression in a load-sharing capacity, ensuring colinear reduction of the distal extremity and achieving relatively high fusion rates with few complications. A brief history of the technique, as well as its indications, contraindications, and relative advantages over other methods of fixation are discussed. The author's clinical series using this technique is presented.