in those cases in which inadequate bone remains, salvage of ankle joint may be brought about by realignment of tibiotalar joint & fusion of subtalar joint or by tibiocalcaneal fusion w/ tricortical bone graft.
this fusion has been used to salvage cases of avascular collapse w/ degenerative changes in the ankle and subtalar joint;
use of this procedure is limited to those pts w/ adequate remaining talar neck to receive the tibial graft.
advantages: maintains relatively normal appearance to the foot, w/ maintenance of alignment, minimizing shortening, and maximizing the remaining subtalar complex range of motion;