TTC & Hindfoot Fusion | Case Report – DynaNail® TTC Fusion System TTC And Hindfoot Fusion Case Report DynaNail TTC | Page 6

20 Weeks Post-Surgery:
The patient had returned to walking
comfortably in rocker-soled shoes; he was
not experiencing any pain and had no
swelling. The Compressive Element had
unloaded a total of 3.1 mm while still
maintaining compression. He was cleared
to return to playing doubles tennis.
Case Report #2
Background Information
A 66 year old man with diabetes mellitus and
Charcot neuroarthropathy of the hindfoot
presented with ankle and subtalar arthritis with a
severe varus deformity. He underwent a TTC
arthrodesis with a standard IM nail through a
posterior approach and was equipped with an
external bone simulator. Successful fusion was
achieved across the subtalar joint, but non-union
of the ankle joint resulted in hardware failure. The
patient experienced no pain but continued to
have swelling at the ankle joint. After one year,
there was no visible bony union of the ankle joint
and a revision TTC fusion was scheduled.
Procedure
The nail and broken screws were removed. The ankle joint was
prepared in standard fashion through an anterior approach. Iliac
crest bone marrow aspirate mixed with crushed cancellous
allograft was used to fill the defect at the tibiotalar joint. A fibular
osteotomy was created to allow compression across the ankle
joint. A 12 x 220 mm DynaNail was placed. The Compressive
Element was stretched 6 mm and 6 mm of manual compression
was applied across the joints. A 65 mm headless P-A screw and
45 mm headed cortical L-M screw were used in the calcaneus.
The proximal and distal tibial cortical screws used were 25 mm
and 30 mm, respectively. An intra-operative X-ray shown to the left
reveals the Compressive Element is stretched 5 mm after screw
insertion with 1 mm of settling occurring during the procedure.
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