Pantalar Fusion

 

Indications

 

Rheumatoid arthritis

 

 

Combined ankle and subtalar joint osteoarthritis

 

Talar AVN

 

 

Trauma

 

Severe Deformity

- acquired flat foot

- neurological conditions

 

 

Surgical Technique

 

1. Prepare joint surfaces

 

Incision

- curved incision

- posterior border fibular

- curved anteriorly along peroneal tendons

- towards 4th MT

 

Exposure AKJ

- excise distal fibular

 

Exposure subtalar joint

- elevate peroneals and EDB

- divide TC interosseous ligament

 

Prepare arthrodesis

- decorticate / remove cartilaginous surfaces

- drill holes

- correct deformity

- ankle joint: 5^o valgus, plantigrade, ER 10^o

- subtalar joint:  5^o valgus

 

2.  Hindfoot nail

 

 

Insertion point

- in line with 2nd metatarsal

- junction of posterior 2/3 and anterior 1/3 heel

- should pass through anterior aspect posterior subtalar joint

 

Insert nail

- distal locking screws calcaneum using jig

- insert bone graft

- compress

- proximal locking

 

Smith and Nephew Hindfoot Fusion Nail Surgical Technique PDF

https://www.smith-nephew.com/global/assets/pdf/products/surgical/71181028_rev0_trigen_hfn_st_lores.pdf

 

 

Synthes Hindfoot Arthrodesis Nail Surgical Technique PDF

http://synthes.vo.llnwd.net/o16/LLNWMB8/US%20Mobile/Synthes%20North%20America/Product%20Support%20Materials/Technique%20Guides/DSUSTRM09141044_TiCannHindFoot_STG_150dpi(2).pdf