Ankle and Subtalar (Double) Fusion using OrthoSolutions Oxbridge nail
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One technique for double fusion of the ankle and subtalar joint is to use fixation with an intramedullary nail such as the OrthoSolutions Oxbridge Nail.
This is a method applicable when both the ankle and subtalar joints are to be fused, which achieves rigid fixation, even in cases of bone loss.
Particular advantages of the Orthosolutions Oxbridge nail are a well designed entry jig to assist centring the initial guide-wire , numerous distal screw option to secure the nail into Calcaneus and Talus coupled with a simple & accurate outrigger to allow lateral , medial and posterior positioning ,multiple synchronous external compression options , a “Mis-a-nail” jig to allow easy placement of a supplementary large screw to improve rotational stability and axial compression for the difficult reconstruction cases and a single, simple tray of instrumentation.
The Oxbridge nail can also be used in conjunction with the custom manufactured 4Web talar replacement for cases of avascular necrosis of the talus https://www.orthoracle.com/library/ttc-double-fusion-using-4web-custom-talar-replacement-and-oxbridge-nail-orthosolutions/
The Wright Valour Nailing system is also detailed on the platform https://www.orthoracle.com/library/tibio-talo-calcaneal-ttc-double-fusion-with-wright-valor-nail/
Irrespective of the means of fixation of the ankle and subtalar joints the principles and techniques involved in fixation of both ankle and subtalar joints are similar. Other forms of fixation of a double fusion include external frames, large fragment screws or plating systems such as the laterally applied Zimmer Ankle-fix https://www.orthoracle.com/library/tibio-talo-calcaneal-ttc-double-fusion-using-zimmer-ankle-fix-plus-plate/
the Integra Advansys plate https://www.orthoracle.com/library/tibio-talo-calcaneal-ttc-double-fusion-using-integra-advansys-plate/
or the posteriorly applied Wright Ortholoc plate https://www.orthoracle.com/library/talectomy-and-tibio-calcaneal-fusion-using-wright-ortholoc-posterior-ttc-fusion-plate/
Author:Paul Cooke FRCS
Institution: The Nuffield Orthopaedic centre, Oxford, UK.