Tibiocalcaneal fusion for the treatment of talar necrosis

Between 1986 and 1996, 21 patients had a tibiocalcanear arthrodesis. Indica tions for surgery were in all cases either osteomyelitis or avascular necro sis of the talus. External stabilisation was used in 17 patients due to sev ere soft tissue damage or extensive infection of the talus, internal screw fixation was used in four patients. There were eight complications in seven patients, one patient had a below the knee amputation. The leg length disc repancies after resection of the talus was equalised in four cases with cal lus distraction using an Ilisarov ring fixator. Follow up evaluation was av ailable in 18 patients after an average of 38 months (12-86 mo.). There wer e no infectious recurrenies during the follow up period and a solid fusion was achieved in all patients that were followed. According to a modified Ki taoka score, results were excellent and good in 12 of the 18 patients. Exte rnal stabilisation, especially the Ilisarov ring fixator is the primary met hod of treatment in cases with severe infection or soft tissue damage.