Tibiotalocalcaneal Fusion with Retrograde Intramedullary Nail for Non-Union/Malunion

Abstract

Tibiotalocalcaneal arthrodesis is considered a safety procedure for non-union/Malunion. This report describes a 75-year-old female patient with distal tibial nonunion and severe post-traumatic deformity following an ankle fracture, presenting with pain and functional limitation. After failure of initial treatment with external fixation, tibiotalocalcaneal arthrodesis using a retrograde intramedullary nail was performed as a salvage procedure. The technique allowed correction of alignment, hindfoot stabilization, and achievement of a plantigrade foot. Postoperative care included cast immobilization and close follow-up, showing satisfactory bone consolidation at three months, no complications, and significant clinical improvement. This case highlights the biomechanical and biological advantages of the retrograde intramedullary nail in complex hindfoot deformities associated with nonunion, demonstrating it as a safe and effective option to restore function and relieve pain.