Patient
Advanced age
Immunosuppression - steroids / Rheumatoid / DM
Malnutrition - Lymphocyte count / Transferrin / Albumin
Vascular disease
Obesity
Poor skin i.e. psoriasis
Previous infection in joint
Infection elsewhere - i.e. UTi
Prolonged hospital admission
Revision surgery
Operative Factors
Preoperative
- 90% load through plafond to talus
- 10% load through lateral talofibular articulation
A. Lateral Ligament Complex
ATFL (Anterior Talo-Fibular Ligament)
- tight in plantar flexion
3 Sesamoids may be present in great toe
- 2 almost always present on plantar aspect of MTPJ
- 1 may be present on plantar aspect of IPJ
MTPJ sesamoids most important
- embedded in FHB tendons
- held together by intersesamoid ligament & plantar plate
- each side of crista / inter-sesamoid ridge
- articulate with plantar facets of 1st MT
Tibial usually larger than fibula