Arthrodese des Talonavikulargelenks

Objective

Realignment of the hindfoot by talonavicular arthrodesis.

Indications

Idiopathic and posttraumatic arthritis of the talonavicular joint with or without malalignment. Optional in flatfoot reconstruction.

Contraindications

General medical contraindications to surgical interventions. Infection.

Surgical technique

Medial, dorsomedial, or dorsal skin incision. Exposure of the talonavicular joint and cartilage removal. Decortication. Reposition of the joint if malaligned. Optional transplantation of corticocancellous bone. Temporary stabilization with Kirschner wires and stabilization with screws, optional with cramps or plates.

Postoperative management

Six weeks nonweightbearing in a long walker boot. Afterwards 2 weeks of progressively weight bearing in a long walker boot. Then full weightbearing in walking shoes with stiff soles. Physiotherapy.

Results

A total of 18 feet in 18 patients with isolated talonavicular arthritis were treated with isolated talonavicular fusion and corticocancellous bone thorough a midline incision. For postoperative management, patients had nonweightbearing for 6 weeks in a long walker boot. Mean follow-up was 14.5 months (range 8–35 months). Mean age was 63.2 years (range 54–72 years). Preoperative Manchester–Oxford Foot Questionnaire (MOXFQ) score was 65.3 (± 5.2); postoperative MOXFQ score was 28.5 (± 7.0). One revision surgery performed due to pseudarthrosis.