Arthroscopic tibiotalocalcaneal arthrodesis with intramedullary nail with fins: a case series.

Abstract

Arthroscopic arthrodesis of the ankle has several advantages compared with open arthrodesis, including a smaller skin incision, less damage to the soft tissue around the joint, a lower risk of skin necrosis and infection, a lower incidence of postoperative infection and swelling, and better preservation of the contour of the surface of the joint, which maintains a larger contact area between the talus and tibia. We successfully performed arthroscopic arthrodesis of the tibiotalocalcaneal joints with intramedullary nails with fins in 9 ankles of 8 patients. Solid fusion was attained in all cases, except for 1 case of nonunion at the subtalar joint. We also corrected the alignment in 1 patient with a varus deformity. The fixation was strong, even in the case of poor bone quality, such as occurs in rheumatoid arthritis. The intramedullary nails with fins allowed for appropriate compression for bone consolidation without loss of rotational stability. Arthroscopic tibiotalocalcaneal arthrodesis, a less-invasive technique than conventional open surgery, is effective treatment, especially in patients with poor skin conditions secondary to diseases such as rheumatoid arthritis and diabetes mellitus.