Complications of Ankle and Tibiotalocalcaneal Arthrodesis

Arthrodesis has remained the mainstay for treating arthritis and deformities of the ankle and hindfoot for more than a century. Formidable technical challenges exist in achieving a successful result, leading to numerous complications as high as 50% in some series. The most frequent complications after tibiotalar and tibiotalocalcaneal arthrodesis involve nonunion, malunion, infection, and wound complications among others. Meticulous preoperative consideration for the technical and biologic issues involved may lead to diminished complication rates. With advances in implant technology, revision arthrodesis can, in most cases, be expected to yield outcomes comparable with those of a primary procedure. Algorithms for the treatment of the most frequent complications are presented.