Ahmet YURTERİ, Numan MERCAN, Ahmet Fevzi KEKEÇ, Fatih TAHAK, Ahmet YILDIRIM
Acta Orthopaedica et Traumatologica Turcica - 2026;60(4):1-10
Objective: To evaluate the clinical and radiographic outcomes of tibiotalocalcaneal (TTC) arthrodesis performed using a lateral transfibular approach with the off-label application of a Proximal Humerus Internal Locking System (PHILOS) plate and to exploratorily assess outcomes according to the use of supplemental medial cannulated screw fixation. Methods: Thirty patients (32 ankles) who underwent TTC arthrodesis between January 2019 and June 2024 and had >=12 months of follow-up were retrospectively reviewed. Demographics, comorbidities, surgical indications, implant configuration, fusion rates, complications, reoperations, and patient satisfaction were analyzed. Subgroup findings regarding medial screw support were evaluated descriptively. Results: The mean follow-up duration was 37.3 +/- 19.2 months, and fusion was achieved in 90.6% (29/32) of ankles. Complications occurred in 18.8% (6/32), including 3 nonunions, 2 peri-implant tibial fractures, and 1 superficial infection. Reoperation was required in 3 ankles (9.4%). Patient-reported satisfaction was "excellent" in 71.9%, "good" in 12.5%, "fair" in 6.3%, and "poor" in 9.4%. Conclusion: Tibiotalocalcaneal arthrodesis performed using the PHILOS plate with a lateral approach demonstrated acceptable fusion and complication rates in this cohort. Subgroup observations regarding supplemental medial screw fixation should be interpreted as exploratory and hypothesis generating.
