Ankle Arthrodesis with Hindfoot Nail and Fibular Strut Autograft as a Limb-salvage Procedure in Patients with Talar Bone Loss

A novel technique for hindfoot arthrodesis using distal fibula strut autograft for talar bone loss is described. A case series of six patients who underwent the novel procedure is presented. Six patients were retrospectively evaluated with traumatic talar injury and subsequent avascular necrosis (AVN) who underwent reconstruction with a novel technique. The primary outcome studied was the rate of radiographic union. Five of the six patients with sufficient follow-up achieved radiographic union. Traumatic talar injury that leads to AVN/pos”raumatic arthritis can be successfully reconstructed with an ipsilateral fibular strut autograft and retrograde ankle arthrodesis nail through the graft. More studies are needed to determine the efficacy of the procedure, including studies with increased power and studies with long-term follow-up. However, the authors propose that this novel technique is a promising option for limb salvage in patients with talar bone loss. (Journal of Surgical Orthopaedic Advances 34(4):211–214, 2025)

Key words: talus, avascular necrosis, ankle, fusion, autograft, hindfoot