Minimally invasive ankle arthrodesis with a retrograde locking nail after failed fusion

Description: A retrograde nail with posterior-to-anterior (PA) locking into os calcis, talus and tibia was used to correct deformity and achieve fusion after failed fusion. A variety of methods have been published to achieve union of the ankle and subtalar joint in a failed fusion situation. We have studied a retrograde locking nail technique through a 2.5-cm incision in the non-weightbearing part of the sole of the foot.
Locking screw insertion was in the sagittal plane (p.a. direction), in talus os calcis and tibial diaphysis using a nail mounted jig. Ten patients were entered in the study (age 27-60 years).
Radiologically and clinically, fusion was achieved in 16 weeks (range, 12-20 weeks). There was no loosening of the implant or implant failure. A leg length discrepancy was avoided using this technique. There was one complication with varus malunion in a heavy smoker which united after corrective osteotomy, revision nailing and bone grafting.
Minimally invasive ankle arthrodesis with a retrograde locking nail after failed fusion K. Mader, C. C. Verheyen, T. Gausepohl, and D. Pennig Strategies Trauma Limb Reconstr. 2007 April; 2(1): 39–47. full text