• 1

    Burns PR, Dunse A: Tibiotalocalcaneal arthrodesis for foot and ankle deformities. Clin Podiatr Med Surg 34: 357, 2017.

  • 2

    Asomugha EU, Hartog D, Bryan D, et al: Tibiotalocalcaneal fusion for severe deformity and bone loss. J Am Acad Orthop Surg 24: 125, 2016.

  • 3

    Gross JB, Belleville R, Nespola A, et al: Influencing factors of functional result and bone union in tibiotalocalcaneal arthrodesis with intramedullary locking nail: a retrospective series of 30 cases. Eur J Orthop Surg Traumatol 24: 627, 2014.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Rammelt S, Pyrc J, Agren PH, et al: Tibiotalocalcaneal fusion using the hindfoot arthrodesis nail: a multicenter study. Foot Ankle Int 34: 1245, 2013.

  • 5

    Dujela M, Hyer CF, Berlet GC: Rate of subtalar joint arthrodesis after retrograde tibiotalocalcaneal arthrodesis with intramedullary nail fixation: evaluation of the RAIN database. Foot Ankle Spec 11: 410, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Lee BH, Fang C, Kunnasegaran R, et al: Tibiotalocalcaneal arthrodesis with the hindfoot arthrodesis nail: a prospective consecutive series from a single institution. J Foot Ankle Surg 57: 23, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7

    Griffin MJ, Coughlin MJ: Evaluation of midterm results of the Panta Nail: an active compression tibiotalocalcaneal arthrodesis device. J Foot Ankle Surg 57: 74, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Peterson KS, Chapman WD, Hyer CF, et al: Short-term radiographic results and technique of tibiotalocalcaneal arthrodesis with a posterior anatomic locking plate. J Foot Ankle Surg 55: 906, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Gorman TM, Beals TC, Nickisch F, et al: Hindfoot arthrodesis with the blade plate: increased risk of complications and nonunion in a complex patient population. Clin Orthop Relat Res 474: 2280, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10

    Devrim O, Avni IB, Abdi K, et al: Tibiotalocalcaneal arthrodesis by using proximal humeral locking plate. Acta Orthop Traumatol Turc 50: 389, 2016.

  • 11

    Fan J, Zhang X, Luo Y, et al: Tibiotalocalcaneal (TTC) arthrodesis with reverse PHILOS plate and medial cannulated screws with lateral approach. BMC Musculoskelet Disord 18: 317, 2017.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Gutteck N, Schilde S, Reichel M, et al: Posterolateral plate fixation with Pantalarlock is more stable than nail fixation in tibiotalocalcaneal arthrodesis in a biomechanical cadaver study. Foot Ankle Surg 26: 328, 2020.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13

    DiDomenico LA, Wargo-Dorsey M: Tibiotalocalcaneal arthrodesis using a femoral locking plate. J Foot Ankle Surg 51: 128, 2011.

  • 14

    Chiodo CP, Acevedo JI, Sammarco VJ, et al: Intramedullary rod fixation compared with blade-plate-and-screw fixation for tibiotalocalcaneal arthrodesis: a biomechanical investigation. J Bone Joint Surg Am 85: 2425, 2003.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Doornink J, Fitzpatrick DC, Boldhaus S, et al: Effects of hybrid plating with locked and nonlocked screws on the strength of locked plating constructs in the osteoporotic diaphysis. J Trauma 69: 411, 2010.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Zhang C, Shi Z, Mei G: Locking plate versus retrograde intramedullary nail fixation for tibiotalocalcaneal arthrodesis: a retrospective analysis. Indian J Orthop 49: 227, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    DeVries JG, Berlet GC, Hyer CF: Predictive risk assessment for major amputation after tibiotalocalcaneal arthrodesis. Foot Ankle Int 34: 846, 2013.

  • 18

    Marin C, Luyten FP, Van der Schueren B, et al: The impact of type 2 diabetes on bone fracture healing. Front Endocrinol (Lausanne) 9: 6, 2018.

  • 19

    Myers TG, Lowery NJ, Frykberg RG, et al: Ankle and hindfoot fusions: comparison of outcomes in patients with and without diabetes. Foot Ankle Int 33: 20, 2012.

  • 20

    Lee M, Choi WJ, Han SH, et al: Uncontrolled diabetes as a potential risk factor in tibiotalocalcaneal fusion using a retrograde intramedullary nail. Foot Ankle Surg 24: 542, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Sammarco VJ: Superconstructs in the treatment of Charcot foot deformity: plantar plating, locked plating, and axial screw fixation. Foot Ankle Clin 2009 14: 393, 2009.

    • PubMed
    • Search Google Scholar
    • Export Citation

Case Review of Tibiotalocalcaneal Arthrodesis with Distal Femoral Locking Plate Through a Lateral Approach

Brian Au Cambridge Foot and Ankle, Newport Beach, CA.

Search for other papers by Brian Au in
Current site
Google Scholar
PubMed
Close
 DPM
and
Howard A. Hewlett Cambridge Foot and Ankle, Newport Beach, CA.

Search for other papers by Howard A. Hewlett in
Current site
Google Scholar
PubMed
Close
 DPM

Background: Herein, we present a case series of tibiotalocalcaneal arthrodesis (TTCA) with a distal femoral locking plate and describe the short-term clinical and radiographic results of the procedure.

Methods: We performed a case review of four patients with hindfoot and ankle pathology who had been treated with a TTCA using a distal femoral locking plate (Depuy Synthes, Zimmer Biomet) by a single surgeon (H.A.H.) from January 2018 to December 2020.

Results: At final follow-up, there was a 75% complication rate (3/4) with two developing a nonunion of the ankle joint and one developing a postoperative wound and surgical site infection.

Conclusions: Lateral locking plate fixation with a distal femoral locking plate system may be an alternative fixation option for tibiotalocalcaneal fusions in complex patients. However, a larger sample size with longer term follow-up is needed to make any significant recommendations on the use of this plating system.

Corresponding author: Brian Au, DPM, Cambridge Foot and Ankle, 1038 East Chapman Avenue, Orange, CA 92866. (E-mail: brian.au@my.rfums.org)
Save