Tibiotalocalcaneal fusion with a retrograde intramedullary nail: clinical and functional outcomes.

Severe arthrosis and deformity of the ankle and subtalar joints are debilitating problems that can be difficult to treat. We retrospectively reviewed and functionally assessed 15 patients who had undergone tibiotalocalcaneal fusion with a retrograde intramedullary nail. The procedure had been a salvage procedure for severe arthrosis and deformity of the ankle and subtalar joints. Minimum follow-up was 2 years. Solid fusion was achieved in 14 of 15 patients. Mean time to union was 16.5 weeks. Ankle-Hindfoot Scale scores showed excellent pain relief at union. Subjective gait disturbances were common postoperatively, though patient satisfaction and the return-to-work rate were high (93% and 80%, respectively). The 12 complications included nonunion, malunion, skin problems, plantar pain, infection, and painful hardware. We advocate using a retrograde nail as a salvage technique in complex posttraumatic or postsurgical settings.