Extended ankle arthrodesis: Tibiotalocalcaneal and pantalar

Abstract

Tibiotalocalcaneal (TTC) fusion and pantalar fusions are salvage procedures for patients with end-stage ankle and hindfoot arthritis or severe malalignment. In many cases, one of these procedures is the only option available to provide patients with a stable, painless, and plantigrade foot. The procedures are technically demanding, requiring operative planning that must take into account the patient’s underlying diagnosis, comorbidities, and malalignment. Various approaches, fixation constructs, and biologic adjuncts may be used in order to obtain fusion. Despite proper surgical technique, complication rates are high across various series given the salvage nature of these procedures. Indications, operative technique, complications, and illustrative cases for TTC and pantalar fusions are reviewed.