Pantalar Fusion

Pantalar Fusion APPantalar Fusion Lateral

 

Indications

 

RA

AKJ and STJ arthritis

Trauma

Deformity

Talar AVN

 

Technique

 

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

- AKJ 5o valgus, plantigrade, ER 10o

- STJ 5o valgus

 

Pantalar Fusion Talus AVN APPantalar Fusion Talus AVN Lateral

 

Fusion with IM nail

- insertion point

- in line with 2nd MT

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

- should pass through anterior aspect posterior subtalar joint

- insert nail

- distal locking screws calcaneum

- insert bone graft

- compress

- proximal locking