Orthogonal Locked Plating for Tibiotalocalcaneal Arthrodesis

Management of concomitant tibiotalar and subtalar arthrosis, particularly in the setting of talar avascular necrosis or deformity, is a challenging problem. There are poor union rates and risk of stress fracture at the proximal aspect of intramedullary devices. Fixation can be poor in the calcaneus and talus with current methods. This study describes the technique of orthogonal plating, using an anatomic precontoured plating system, for tibiotalocalcaneal arthrodesis, with and without bulk allograft. We feel this technique provides increased construct stability and good outcomes, and 2 of our cases are presented that underwent arthrodesis using this construct at a single academic center. Level of Evidence: Therapeutic level IV, case series. See Instructions for Authors for a complete description of levels of evidence.