Technique Tip: Temporary Tibiotalar Pinning to Facilitate Hindfoot Arthrodesis

摘要

Multiple arthrodeses in the hindfoot can be technically challenging due to many factors: quality of the bone, deformity, osseous defect, positioning of the hindfoot, and others. One frequently encountered challenge is maintaining the proper position of the tibiotalar joint during the procedure. Because of the natural tendency of the foot to assume an equinus and inverted position, it is difficult to keep the ankle in neutral while trying to anatomically position the adjacent tarsal bones for arthrodesis. We describe a technique that has been effective at maintaining a plantigrade position of the foot intraoperatively during complex hindfoot arthrodesis. This simple technique stabilizes the talus in the ankle mortise, allowing the subsequent arthrodesis procedure to be "built around" a neutral ankle. Large transarticular pins have been used for prolonged periods of time as an adjunct to the treatment of neuropathic ankle fractures without complication.1 The current technique uses much smaller pins for only the duration of the operative procedure, and we have not observed any deleterious effect on the tibiotalar joint. Our literature search failed to reveal this technique described in the English literature.