Off-label use of a PHILOS plate in tibiotalocalcaneal arthrodesis with variable medial cannulated screw support: a retrospective evaluation of 32 ankles

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Yurteri A., Mercan N., Kekeç A. F., Tahak F., Yıldırım A.

Acta Orthopaedica et Traumatologica Turcica, cilt.60, sa.4, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 60 Sayı: 4
  • Basım Tarihi: 2026
  • Doi Numarası: 10.5152/j.aott.2026.25553
  • Dergi Adı: Acta Orthopaedica et Traumatologica Turcica
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Directory of Open Access Journals, Biomedical Reference Collection: Corporate Edition (EBSCO)
  • Anahtar Kelimeler: Ankle, Ankle arthrodesis, Bone fusion, Foot and ankle, PHILOS plate, Tibiotalocalcaneal arthrodesis
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Sağlık Bilimleri Üniversitesi Adresli: Evet

Özet

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. Level of Evidence: Level IV, Therapeutic Study.