Open Posterior Approach for Tibiotalar Arthrodesis

The posterior approach offers several advantages as a salvage technique. The use of a blade plate affords axial and rotational stability and the potential for compression. Compromised anterior soft tissue is avoided, and there is ample posterior soft tissue coverage of hardware and bone graft material. With the patient prone, all planes of ankle and foot alignment may be easily viewed clinically and with fluoroscopy, and access to the posterior iliac crest allows for a large volume of bone graft or bone marrow aspirate. In addition, access to the distal tibia, talus, and calcaneus is achieved with this incision, allowing for rigid fixation of the tibiotalar or TTC joints as well as enabling for removal of TAA implants.