We positioned the patient in lateral decubitus, with a tourniquet positioned
proximally to the thigh. The surgical drape allowed visualization of the entire
leg starting from the knee to control the foot and ankle rotation during
arthrodesis. We chose a lateral, transmalleolar approach by resecting the distal
portion of the fibula and using it as a graft.
After osteotomy in the fibula, we obtained complete access to the ankle and
subtalar joints. The joints were prepared under direct visualization by
resecting the cartilage of both surfaces with osteotomes, followed by bone
perforations with Kirschner 2.0 wires.
The ankle and hindfoot were positioned with 90 degrees of dorsiflexion in
correlation to the tibia, 5 degrees of the calcaneus valgus, external rotation
of 10 to 15 degrees, provisionally fixating with Kirshner 2.0 wires, taking care
not to be in the possible path of the screws or nail.
proximally to the thigh. The surgical drape allowed visualization of the entire
leg starting from the knee to control the foot and ankle rotation during
arthrodesis. We chose a lateral, transmalleolar approach by resecting the distal
portion of the fibula and using it as a graft.
After osteotomy in the fibula, we obtained complete access to the ankle and
subtalar joints. The joints were prepared under direct visualization by
resecting the cartilage of both surfaces with osteotomes, followed by bone
perforations with Kirschner 2.0 wires.
The ankle and hindfoot were positioned with 90 degrees of dorsiflexion in
correlation to the tibia, 5 degrees of the calcaneus valgus, external rotation
of 10 to 15 degrees, provisionally fixating with Kirshner 2.0 wires, taking care
not to be in the possible path of the screws or nail.
