Tibiotalar arthrodesis with iliac crest bone grafting

The iliac bone graft for the treatment of sequelae of poliomyelitis. Structural bony deformities must be corrected before the tendon transposition. There are five kinds of stable surgery for foot and ankle: 1 calcane osteotomy; 2 articular subtalar arthrodesis; 3 three-joint fusion; 4 ankle arthrodesis; 5 bone blockage to limit ankle joint activity. These procedures can be used alone or in combination with other procedures. The choice of surgery depends on the age of the sick child and the particular deformity that must be corrected. Treating diseases: polio sequelae polio Indication The iliac bone grafting is suitable for the recurrence of malformations after the skeletal immature pedicure or triple joint fusion. Preoperative preparation Regular preoperative examination. Surgical procedure Chuinard and Peterson Law: 1. Make a longitudinal incision in front of the ankle joint and enter between the long extensor tendon and the long extensor tendon. The anterior tibial vascular nerve was pulled inward and the lower ankle joint capsule was removed from the anterior border of the tibia. Articular cartilage was removed from the tibia and talus in the horizontal direction with an osteotome and a hammer, but the cartilage of the tibia and talus perpendicular articular surface and the tibial articular surface was not removed, and the bone surface was appropriately wedge-shaped to correct the deformity. Be careful to avoid damage to the tarsal plate at the distal end of the tibia. 2. Use a bone chisel with the same width as the width of the ankle to remove a full-thickness graft from the anterior aspect of the ankle. The width is equal to that of the ankle. The length is equal to the anteroposterior diameter of the ankle joint, and the anterior superior iliac spine remains. The bone is trimmed to fit the size of the file and some holes are drilled on it with a bone drill. The ankle joint space was separated by hand, and the bone graft was inserted into the bone graft to make it face wide, and the bone graft surface was in close contact with the tibia and the talus surface. Check the position of the foot and adjust it so that it is in the neutral position. The residual space was filled with cancellous bone taken from the tibia and the incision was closed.

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