Abstract
The purpose of this study was to evaluate the radiographic and clinical outcomes of
isolated talonavicular arthrodesis in the treatment of the flexible pes valgus foot
type. Retrospectively, 51 consecutive isolated talonavicular arthrodeses in 41 patients
were evaluated. The mean patient age was 47 (range 9 to 72) years, and the mean follow-up
duration was 43.3 (range 11 to 113) months. The mean 10-cm categorical pain score
before the surgery was 7.60 ± 2.37, and this improved to 1.90 ± 2.38 postoperatively,
and this difference was statistically significant (P < .001). We also measured the preoperative and postoperative percent of talar uncovering,
calcaneocuboid angle, Kite's angle, talar dome height, calcaneal inclination angle,
and Meary's angle, and observed statistically significant (P < .001) improvements in all of these. Fifty-one (100%) of the cases progressed to
radiographic osseous union, although 2 (3.92%) of the cases were considered delayed
unions. Moreover, 4 (7.84%) of the cases displayed juxta-articular arthrosis postoperatively,
and 2 (3.9%) cases developed transfer pain to the lateral column. The authors concluded
that isolated talonavicular arthrodesis is a safe and effective procedure for the
treatment of painful pes valgus deformity.
Level of Clinical Evidence
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Biomechanics of procedures used in adult flatfoot deformity.Foot Ankle Clin. 2001; 6: 15-23
- Flatfoot in the adult.J Am Acad Orthop Surg. 1995; 3: 293-302
- Biomechanics and pathophysiology of flat foot.Foot Ankle Clin. 2003; 8: 419-430
- Adult acquired flat foot deformity: clinical and radiographic examination.Foot Ankle Clin. 2003; 8: 431-452
- Tibialis posterior tendon dysfunction.Clin Orthop Relat Res. 1989; 239: 196-206
- Adult acquired flatfoot deformity: treatment of dysfunction of the posterior tibial tendon.Instr Course Lect. 1997; 46: 393-405
- Stage IV posterior tibial tendon rupture.Foot Ankle Clin. 2007; 12: 341-362
- Tibialis posterior tendon rupture.J Am Podiatr Med Assoc. 1987; 77: 170-176
- Downey M.S. Banks A.S. Martin D.E. Miller S.J. ed 3. McGlamry's Comprehensive Textbook of Foot and Ankle Surgery. vol. II. Lippincott Williams & Wilkins, Philadelphia2001: 799-862
- Subluxation of the talocalcaneal joint in adults who have symptomatic flatfoot.J Bone Joint Surg Am. 1999; 81: 1147-1154
- Isolated medial column stabilization improves alignment in adult-acquired flatfoot.Clin Orthop Relat Res. 2005; 435: 197-202
- Medial column procedures in the acquired flatfoot deformity.Foot Ankle Clin. 2007; 12: 287-299
- Sands AK Lateral-sided bony procedures.Foot Ankle Clin. 2003; 8: 563-567
- Lengthening of the lateral column and reconstruction of the medial soft tissue for treatment of acquired flatfoot deformity associated with insufficiency of the posterior tibial tendon.Foot Ankle Int. 1999; 20: 622-629
- Treatment of stage II posterior tibial tendon deficiency with flexor digitorum longus tendon transfer and calcaneal osteotomy.Foot Ankle Int. 2004; 25: 445-450
- Talar neck osteotomy for flatfoot reconstruction: a 27-year follow-up study.Clin Podiatr Med Surg. 2006; 23: 41-55
- The algorithmic approach to pediatric flexible pes planovalgus.Clin Podiatr Med Surg. 2006; 23: 57-76
- Operative treatment of the difficult stage 2 adult acquired flatfoot deformity.Foot Ankle Clin. 2001; 6: 95-119
- Deformity and degeneration in the hindfoot and midfoot joints of the adult acquired flatfoot.Foot Ankle Int. 2003; 24: 530-534
- Correction of moderate and severe acquired flexible flatfoot with medializing calcaneal osteotomy and flexor digitorum longus transfer.J Bone Joint Surg Am. 2006; 88: 1726-1734
- Orthopadische Operationslehre.(pp 29–31) Ferdinand Enke, Stuttgart1913
- Selected rearfoot arthrodesis.in: Downey M.S. Banks A.S. Martin D.E. Miller S.J. ed 3. McGlamry's Comprehensive Textbook of Foot and Ankle Surgery. vol. II. Lippincott Williams & Wilkins, Philadelphia2001: 1193-1218
- Gait analysis after talonavicular joint fusion: 2 case reports.J Foot Ankle Surg. 2004; 43: 241-247
- Hoke triple arthrodesis.J Bone Joint Surg Am. 1978; 60: 795-798
- Talonavicular arthrodesis.Clin Podiatr Med Surg. 2004; 21: 227-240
- Talonavicular arthrodesis for isolated arthrosis: 9.5-year results and gait analysis.Foot Ankle. 1982; 3: 105-113
- Talonavicular arthrodesis for rheumatoid arthritis of the hindfoot.Orthop Clin North Am. 1976; 7: 821-826
- Talonavicular arthrodesis in the rheumatoid foot.Foot Ankle. 1992; 13: 313-316
- Talonavicular fusion with bone graft for spastic arthritic flat foot.Surg Clin North Am. 1969; 49: 883-887
- Arthrodesis techniques in the management of stage II and III acquired adult flatfoot deformity.Instr Course Lect. 2006; 55: 531-542
- Surgical treatment of acquired flatfoot deformity: what is the state of practice among academic foot and ankle surgeons in 2002?.Foot Ankle Int. 2003; 24: 701-705
- Hindfoot arthrodesis for the adult acquired flat foot.Foot Ankle Clin. 2003; 8: 569-594
- Complications of surgical treatments for adult flatfoot deformities.Foot Ankle Clin. 2001; 6: 179-191
- Talonavicular arthrodesis and Evans calcaneal osteotomy for treatment of posterior tibial tendon disfunction.J Foot Ankle Surg. 1999; 38: 116-122
- Motion of the hindfoot after simulated arthrodesis.J Bone Joint Surg Am. 1997; 79: 241-246
- Selective hindfoot arthrodesis for the treatment of adult acquired flatfoot deformity: an in vitro study.Foot Ankle Int. 1995; 16: 411-417
- Double arthrodesis in the adult.Clin Orthop Relat Res. 1999; 365: 74-80
- Posterior tibial tendon insufficiency. Isolated fusion of the talonavicular joint.Foot Ankle Clin. 2001; 6: 137-151
- Talonavicular arthrodesis for the acquired flatfoot in the adult.Clin Orthop Relat Res. 1999; 365: 65-68
- Talonavicular arthrodesis for the painful adult acquired flatfoot.Foot Ankle Int. 1996; 17: 658-661
Article info
Publication history
Published online: December 16, 2009
Footnotes
Financial Disclosure: None reported.
Conflicts of Interest: None reported.
Identification
Copyright
© 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
