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Concerns regarding ankle pathologies with large bone
defects include how to choose an appropriate treatment, the
lower fusion rate with arthrodesis, and the long treatment
period needed for difficult hindfoot reconstructions. Our
procedure allowed easy access, provided a wide view of the
ankle, and allowed for the use of a local fibular graft to fill
the defect and avoided iliac bone harvest, which sometimes
leads to patient complaints. Retrograde intramedullary nailing is a commonly used procedure that provides stability. A
soft tissue-preserved fibular strut autograft should restore
blood supply, give high fusion rates, and may be applicable
to infection cases.
We conclude from our experiences that this procedure
does not require special techniques and it should be applicable to complicated cases with large bone defects. High
fusion rates due to preserving the blood supply to the
fibular autograft was found with preservation of the hindfoot height.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect
to the research, authorship, and/or publication of this article.

Funding
The author(s) received no financial support for the research,
authorship, and/or publication of this article.

References
1. Bishop AT, Wood MB, Sheetz KK. Arthrodesis of the ankle
with a free vascularized autogenous bone graft. J Bone Joint
Surg Am. 1995;77(12):1867-1875.

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2. Buck P, Morrey BF, Chao EY. The optimum position of
arthrodesis of the ankle. A gait study of the knee and ankle. J
Bone Joint Surg Am. 1987;69(7):1052-1062.
3. Cobey JC. Posterior roentgenogram of the foot. Clin Orthop
Relat Res. 1976;118:202-207.
4. Dennison MG, Pool RD, Simonis RB, et al. Tibiocalcaneal
fusion for avascular necrosis of the talus. J Bone Joint Surg
Br. 2001;83(2):199-203.
5. DeVries JG, Philbin TM, Hyer CF. Retrograde intramedullary
nail arthrodesis for avascular necrosis of the talus. Foot Ankle
Int. 2010;31(11):965-972.
6. Frigg A, Nigg B, Davis E, et al. Does alignment in the hindfoot radiograph influence dynamic foot-floor pressures in
ankle and tibiotalocalcaneal fusion? Clin Orthop Relat Res.
2010;468:3362-3370.
7. Gross C, Erickson BJ, Adams SB, et al. Ankle arthrodesis
after failed total ankle replacement: a systematic review of
the literature. Foot Ankle Spec. 2015;8(2):143-151.
8. Rammelt S, Pyrc J, Agren PH, et al. Tibiotalocalcaneal fusion
using the hindfoot arthrodesis nail: a multicenter study. Foot
Ankle Int. 2013;34(9):1245-1255.
9. Tenenbaum S, Stockton KG, Bariteau JT, et al. Salvage of
avascular necrosis of the talus by combined ankle and hindfoot arthrodesis without structural bone graft. Foot Ankle Int.
2015;36(3):282-287.
10. Thomason K, Eyres KS. A technique of fusion for failed total
replacement of the ankle: tibio-allograft-calcaneal fusion with
a locked retrograde intramedullary nail. J Bone Joint Surg Br.
2008;90(7):885-888.
11. Van Bergeyk A, Stotler W, Beals T, et al. Functional outcome
after modified Blair tibiotalar arthrodesis for talar osteonecrosis. Foot Ankle Int. 2003;24(10):765-770.
12. Yajima H, Kobata Y, Tomita Y, et al. Ankle and pantalar
arthrodeses using vascularized fibular grafts. Foot Ankle Int.
2004;25(1):3-7.

Table of Contents for the Digital Edition of Foot & Ankle International - June 2017