[Triple arthrodesis in rigid foot deformities and the effect of internal fixation on clinical and radiographic results].
OBJECTIVE
We evaluated the results of triple arthrodesis in rigid foot deformities and assessed the effect of internal fixation on clinical and radiographic results.


METHODS
Thirty feet of 26 patients (12 females, 14 males; mean age 27 years; range 13 to 55 years) were treated with classic triple arthrodesis. Ten patients (12 feet) underwent temporary internal fixation with one or more Kirschner wires. Clinical evaluations were made with the use of both AOFAS (American Orthopaedic Foot and Ankle Society) and Angus-Cowell ankle-hindfoot scoring systems. Anteroposterior and lateral talocalcaneal and talus-first metatarsal angles were used as radiographic parameters. The mean follow-up period was 80.3 months (range 30 to 140 months).


RESULTS
The mean AOFAS score increased from a preoperative 39.3 (range 16 to 59) to postoperative 90.8 (range 71 to 94). According to the Angus-Cowell criteria, the results were good in 19 feet (63.3%), fair in eight feet (26.7%), and poor in three feet (10%). Clinical improvement was statistically significant according to both scoring systems (p<0.05). Radiographically, all the angular values were within normal limits both in the early postoperative period and at the last follow-up (p<0.05). Pseudoarthrosis was detected in four feet (13.3%) and degeneration of the ankle and naviculocuneiform joints was detected in 12 feet (40%) and 17 feet (56.7%), respectively. Internal fixation had no significant effect on pseudoarthrosis, residual or recurrent deformity, and the degree of degeneration (p>0.05).


CONCLUSIONS
Triple arthrodesis is a good alternative for functional and cosmetic improvement in foot deformities. Although internal fixation seems to have no significant effect, the use of a temporary fixation material may contribute to maintenance of reduction and surface contact.
Doğan
Ahmet
A
Department of Orthopedics and Traumatology (1. Ortopedi ve Travmatoloji Kliniği), Istanbul Training and Research Hospital, Istanbul, Turkey. orthopaedy@hotmail.com
Albayrak
Mehmet
M
Uğur
Fatih
F
Zorer
Gazi
G
D000293:Adolescent; D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D005260:Female; D005530:Foot Deformities / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012720:Severity of Illness Index; D016896:Treatment Outcome