Tibio-talo-calcaneal(double) fusion using De Puy Versa-Nail
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The fixation of a double fusion using an intra-medullary nailing technique is one of the commoner options utilised for combined Ankle and Subtalar degenerative change with or without deformity. It is a technique that should also be considered in revision ankle fusion cases without Subtalar arthritis and neurological cases presenting with ankle and hindfoot instability rather than deformity.
In the correct patient (and using intra-medullary nail fixation) early load bearing may be achievable. Union rates in many published series are in excess of 90%.
It can however be a technically challenging and relatively long operation to perform.
The implant technique detailed is for the De Puy Versa-nail but the preparation of the arthrodesis described is the same irrespective of the implant type and to a large extent the technique also. A number of the technical details relating to the required steps during intra-medullary nailing are also shared with other nailing systems.
OrthOracle readers will also find the following associated techniques of interest:
Talectomy and tibio-calcaneal fusion using Wright Ortholoc posterior TTC fusion plate
Tibio-Talo-Calcaneal (TTC/Double )fusion using Zimmer Ankle Fix plus plate.
Tibio-Talo-Calcaneal (TTC/Double )fusion using Integra Advansys Plate
Tibio-talo-calcaneal (TTC/Double ) fusion with Wright Valor nail.
Author: Mark Herron FRCS
Institution: The Wellington Hospital, London, UK.
Clinicians should seek clarification on whether any implant demonstrated is licensed for use in their own country.
In the USA contact: fda.gov
In the UK contact: gov.uk
In the EU contact: ema.europa.eu