[Arthroscopic tibiotalocalcaneal arthrodesis using an intramedullary locking nail].

[Arthroscopic tibiotalocalcaneal arthrodesis using an intramedullary locking nail].
Oper Orthop Traumatol. 2020 Jan 10;:
Authors: Baumbach SF, Maßen F, Böcker W, Polzer H
Abstract
OBJECTIVE: Arthroscopic tibiotalocalcaneal arthrodesis (TTCA) aims at reconstructing a pain-free, orthograde, and functional limb with reduced invasiveness and lower complication rates compared to open arthrodesis.
INDICATIONS: Combined osteoarthritis of the ankle and subtalar joint or hindfoot malalignment.
CONTRAINDICATIONS: Osteomyelitis/deep soft tissue infections, talus necrosis, severe deformity of hindfoot or distal tibia, pronounced boney defect, indication for combined total ankle replacement and subtalar fusion.
SURGICAL TECHNIQUE: Patient in supine position; arthroscopic debridement of the cartilage and subchondral zone, perforation of the subchondral bone marrow of the ankle and subtalar joint. Foot and hindfoot positioning. Special attention has to be paid to the calcaneus and talus inclination, hindfoot alignment and rotation. Temporary fixation, insertion of the guide wire, reaming and insertion of the retrograde, curved compression arthrodesis nail. If needed, autologous bone grafting. Proximal locking of the nail, application of compression, distal locking, wound closure.
POSTOPERATIVE MANAGEMENT: Lymphatic drainage, physical therapy, and restricted bed rest until wound healing. Non-weightbearing, immobili...

Source: Operative Orthopadie und Traumatologie - January 9, 2020 Category: Orthopaedics Authors: Baumbach SF, Maßen F, Böcker W, Polzer H Tags: Oper Orthop Traumatol Source Type: research