title: Tibiotalocalcaneal Fusion for Severe Deformity and Bone Loss.
abstract: Tibiotalocalcaneal fusion is an effective salvage procedure for combined end-stage ankle and subtalar arthrosis and for the management of severe planar deformities of the ankle and hindfoot. Although the procedure results in a rigid ankle and hindfoot, it is often the only means of providing patients with a stable and painless foot and ankle for ambulation. Some patients who require the procedure have substantial bone loss that can be managed with a variety of autograft and allograft options. Options for tibiotalocalcaneal fixation include both internal and external devices, the selection of which depends on the underlying pathology, amount of bone loss, and type of bone graft selected. Relatively high complication rates associated with tibiotalocalcaneal fusion have been reported, with complications ranging from superficial infection to ultimate amputation; however, proper patient selection and careful graft and fixation planning can minimize the postoperative complications of the procedure.
authors.affiliation: From the Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH (Dr. Asomugha), Black Hills Orthopedic & Spine Center, Rapid City, SD (Dr. Den Hartog), the Department of Orthopedics, Summa Health, Akron, OH (Dr. Junko), and the Department of Orthopaedic Surgery, Wexner Medical Center, Ohio State University, Columbus, OH (Dr. Alexander).
authors.forename: Eva U
authors.initials: EU
authors.lastname: Asomugha
authors.forename: Bryan D
authors.initials: BD
authors.lastname: Den Hartog
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Junko
authors.forename: Ian J
authors.initials: IJ
authors.lastname: Alexander
mesh_terms: D000843:Ankle Joint / Q000601:surgery*; D001174:Arthrodesis / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001858:Bone Nails; D001860:Bone Plates; D001863:Bone Screws; D016025:Bone Transplantation; D002111:Calcaneus / Q000601:surgery*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D010003:Osteoarthritis / Q000601:surgery; D018579:Patient Selection; D013977:Tibia / Q000601:surgery*; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous