PMC4756181_01
Assessment of ankle joint; (A, B) anterior-posterior and lateral radiographs, showing implant failure, pseudarthrosis and joint destruction; (C) CT image; and (D, E) weight bearing and ankle movements after initial surgery.
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Pseudarthrosis of the distal tibial metaphysis, implant failure and an intra-articular defect were identified on imaging (Fig. 1A-E).
Appearance of the medial ankle joint defect after removal of the implants (A); application of tricortical iliac crest autologous bone grafting (TCG) to the tibial plafond of the ankle joint surface (B); pre-operative fluoroscopy images before and after autografting (C); and anterior-posterior and lateral radiographs in the early post-operative period with cast in situ (D, E).
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A short leg cylinder cast was applied and maintained for 6 weeks post-surgery (Fig. 2A-D).
Radiological and clinical results in post-operative year 13; (A) standing anterior-posterior radiographs; (B) lateral radiographs in maximum plantar and dorsal flexion positions; (C) coronal, sagittal and axial computed tomography images of the tibiotalar joint; and (D) clinical results.
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Computed tomography (CT) images demonstrated remodeling of the TCG in congruity with the talar dome and preservation of the joint space (Figs. 3A-D and 4A-D ).
Clinical and radiological results during the final check of our patient at postoperative 14 years. Anterior-posterior and lateral radiographies of ankle (A, B), ankle's BT display (C) and ankle's clinical photographs (D).
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Computed tomography (CT) images demonstrated remodeling of the TCG in congruity with the talar dome and preservation of the joint space (Figs. 3A-D and 4A-D ).