Nonresection triple arthrodesis: a retrospective analysis.
This case series examines triple arthrodesis using articular cartilage excision without bone resection. Due to the technically demanding nature of triple arthrodesis, the authors present a nonresection technique with its perceived advantages over joint resection triple arthrodesis in the presence of reducible deformity, such as minimal shortening of bone, ease of execution, and better bony apposition. Fourteen patients with nonresection triple arthrodesis from two medical centers are included in this report. Postoperative follow-up ranged from 6 to 36 months. Evaluation of results was performed subjectively and radiographically. There was a low incidence of nonunion (2% of joints) and minimal to no bone shortening (0.1 cm mean talonavicular shortening and 0.1 cm mean increase in talocalcaneal height). Mean time to fusion of joints fixed with screws was 9.91 weeks (SD = 3.61, n = 31), while fusion time for staple or pin fixation was 8.96 weeks (SD = 4.15, n = 10). There were no significant differences in time to fusion between screw and nonscrew fixation (p = .26) nor when comparing procedures within each patient (p = .30). At follow-up, five patients reported no pain at any time (36%); two patients reported mild occasional pain (14%). Moderate, daily pain was reported by seven patients (50%). While no direct comparison with resection triple arthrodesis was made, the positive subjective and objective results support this procedure.
Kissel
C G
CG
Section of Podiatric Surgery, Hutzel Hospital/Detroit Medical Center, MI, USA.
Hulst
T J
TJ
Blacklidge
D K
DK
Raynor
K J
KJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D002358:Cartilage, Articular / Q000601:surgery*; D005260:Female; D005530:Foot Deformities / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011859:Radiography; D012189:Retrospective Studies; D016879:Salvage Therapy; D013640:Tarsal Joints / Q000000981:diagnostic imaging / Q000601:surgery*