[Stabilization of the hindfoot by talonavicular arthrodesis. Results apropos of 50 cases].
Hindfoot stabilization can be obtained by an isolated talonavicular arthrodesis as well as a triple arthrodesis.


METHODS
There were 27 cases of unstable neurological foot, 13 cases of Rhumatoid foot, 7 cases of flat feet and 3 cases of post-trauma arthritis of the talonavicular joint. The procedure was, in all cases, a talonavicular arthrodesis, associated in some cases to a lengthening of the Achilles tendon, tendon transfer and forefoot correction.


METHODS
50 cases were reviewed with a mean follow-up of 40 months.


RESULTS
There were 18 per cent cases of non-union. This could be explained by 2 technical errors: bad cartilagenous resection of the surfaces and unstable bone fixation. No subtalar mobility was noted in all cases. Only one case had a midtarsal mobility associated to a non-union. 39 feet had a normal heel axation. In most cases functional improvement was significant with a painless gait.


CONCLUSIONS
Hindfoot stabilization can be obtained by an isolated talonavicular arthrodesis. Non-union could be avoided by a better surgical technique and a cast immobilization of 2 and a half months. The pre-operative deformities should be reduced manually, because isolated fixed valgus and varus can not be corrected by an isolated talonavicular arthrodesis. In conclusion, the indications are: An early valgus deformity of the hindfoot in rhumatoid arthritis. The aim is to avoid a fixed valgus deformity. Neurological induced equino varus deformities specially after stroke and other reducible neurological deformities. Flat foot due to posterior tibialis insufficiency. Isolated arthritis of the talonavicular joint.
Asencio
G
G
Service de Chirurgie Orthopédique et Traumatologique, CHU Gaston Doumergue, Nîmes.
Roeland
A
A
Megy
B
B
Bertin
R
R
Fouque
E
E
Leclerc
V
V
D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005530:Foot Deformities / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016059:Range of Motion, Articular; D013628:Talus / Q000601:surgery*; D013640:Tarsal Joints
Stabilisation de l'arrière-pied par arthrodèse astragalo-scaphoïdienne. Résultats à propos de 50 cas.