Method of Tibiocalcaneal Arthrodesis for a Total Defect of the Talus in Patients with Charcot Neuroarthropathy

Background. At present, treatment of patients with Charcot neuroarthropathy remains an unsolved problem. The current state of the problem motivated us to develop a new original method of hindfoot reconstruction aimed to form a tibiocalcaneal bone block with maximum possible preservation of limb length in patients with Charcot neuroarthropathy. The aim of the paper was to demonstrate a new one-stage tibiocalcaneal arthrodesis technique aimed at preserving maximum possible limb length. Surgical technique description. At the preoperative stage, the angle adjacent to the Gissan angle and its bisector is measured on X-rays. After performing the Kocher ankle approach with subsequent lateral malleolus resection and osteonecrectomy, the distal metaepiphysis of the tibia is cut in an oblique-horizontal plane at the bisector angle, open posteriorly and equal to the preoperatively measured value. The resulting triangular bone fragment is rotated by 180º and adapted within the external fixator. Conclusion. The proposed method for total talar destruction in patients with Charcot neuroarthropathy is convenient and simple for adapting incongruent calcaneal and tibial surfaces and allows reducing the lower limb shortening in tibiocalcaneal arthrodesis. © 2025 Elsevier B.V., All rights reserved.