The Case for Selective Arthrodesis—Middle of the Road Stance

In between talonaviculocuneiform (TNC) arthrodesis and all joint-preserving surgery, there is a growing trend towards directing arthrodesis according to the joints involved in Müller-Weiss diseaseMüller-Weiss disease, as determined by clinical assessment and plain radiographs, and confirmed by either CT, MRI, SPECT-CT orSPECT-CT diagnostic injections. None of the Wong Group 1 early-onset disease has required surgery so far. Fusion surgery in Group 2 Müller-Weissoid feet and Group 3A affecting the talonavicular joint only consisted of talonavicular or triple arthrodesisTriple arthrodesis with a preference towards conserving the calcaneocuboid jointCalcaneocuboid joint to preserve motion at the lateral column and performing a double medial arthrodesisDouble medial arthrodesis instead. In both Groups 3B and 3C, TNC arthrodesis is performed supplemented with interpositional tricortical iliac crest bone graft in case of fracture or inadequate bone stock at the lateral navicularNavicular. In Group 3B, consideration can be given to performing isolated talonavicular arthrodesisTalonavicular arthrodesis if the naviculocuneiform joints are not symptomatic and medial talonavicular subluxationTalonavicular subluxation is adequately reduced.