Limb Salvage by Means of Hindfoot Arthrodesis Utilizing Bulk Allograft and External Fixation.

Abstract

Format: Retrospective Review.

Length of follow-up: 18 months.

Classification: Rearfoot and Ankle Reconstruction.

Methodology: Level 4 Retrospective Review.

Procedures: A retrospective review was performed of 6 patients who had undergone limb salvage procedures between January 2016 and April 2019. Patients underwent surgery due to severe limb-threatening diagnosis including Charcot and/or osteomyelitis. Salvage arthrodesis was performed with bulk femoral head allograft incorporation using a hexapod external fixation system. The external fixation was retained for an average of 16 weeks. All patients were followed for a postoperative period of 16 months.

Results: Successful rearfoot arthrodesis and limb salvage was achieved in ⅚ (83%) of patients.

Discussion: This review demonstrates that limb salvage and arthrodesis are possible using femoral head allograft incorporation by external fixation alone. The involved patients had resolution of the osteomyelitis and Charcot deformity, salvage arthrodesis of the rearfoot and avoidance of a major limb amputation.

Levels of evidence: IV.