Tibiotalocalcaneal Arthrodesis Using a Nitinol Intramedullary Hindfoot Nail.
Tibiotalocalcaneal (TTC) arthrodesis using an intramedullary hindfoot nail is a common procedure for deformity correction and the treatment of combined tibiotalar and subtalar end-stage arthritis. Nonunion at one or both fusion sites is a difficult complication that can result in reoperation, significant morbidity, and below-knee amputation. There is currently a need for sustained compression across fusion sites using a TTC hindfoot nail with good mechanical stability. The DynaNail TTC Fusion System (MedShape, Inc, Atlanta, GA) uses an internal nitinol compression element to apply sustained compression across the tibiotalar and subtalar joints after surgery. In preliminary clinical cases, we have found that the nail is safe, reliable, and has promising clinical and radiographic results in settings of hindfoot arthritis, complex deformity, Charcot arthropathy, and talar avascular necrosis.


METHODS
Expert opinion, Level V.
OrthoCarolina Foot & Ankle Institute, Charlotte, North Carolina (ARH, JKE)Department of Orthopeadic Surgery, Duke University Medical Center, Durham, North Carolina (SBA) andyhsu1@gmail.com.
Andrew R
AR
Hsu
OrthoCarolina Foot & Ankle Institute, Charlotte, North Carolina (ARH, JKE)Department of Orthopeadic Surgery, Duke University Medical Center, Durham, North Carolina (SBA).
J Kent
JK
Ellington
OrthoCarolina Foot & Ankle Institute, Charlotte, North Carolina (ARH, JKE)Department of Orthopeadic Surgery, Duke University Medical Center, Durham, North Carolina (SBA).
Samuel B
SB
Adams
D000328:Adult; D000497:Alloys; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D001177:Arthropathy, Neurogenic / Q000000981:diagnostic imaging / Q000601:surgery; D001858:Bone Nails; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D018570:Risk Assessment; D013380:Subtalar Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
D000497:Alloys; C013616:nitinol
ankle injuries; ankle, Charcot’s disease; diagnostic and therapeutic techniques; foot surgery techniques; heel; neurological problems; rearfoot