Arthrodesis of the talonavicular joint using angle-stable mini-plates: a prospective study.
OBJECTIVE
The talonavicular joint is a central connection of the human foot. Symptomatic talonavicular arthritis can be adequately addressed by isolated talonavicular fusion. However, non-union remains a relevant clinical challenge to the orthopaedic surgeon. The aim of this study was to analyse the clinicoradiological outcome of talonavicular fusion using angle-stable mini-plates.


METHODS
We performed 30 talonavicular fusions in 30 patients (12 male, 18 female) with a mean age of 58.8 years (range, 22-74) between 2005 and 2007. Osseous joint fusion was achieved using mono- and multidirectional angle-stable mini-plates. The patients followed a standardised immobilisation and weight bearing protocol. The mean postoperative follow up was 15.8 months (6.1-23.8).


RESULTS
The American Orthopedic Foot and Ankle Society AOFAS score increased significantly from 31.7 (19-42) to 82.3 points (55-97) (p < 0.001). Neither age at operation nor gender influenced the score results significantly, while the aetiology of talonavicular degeneration showed a significant effect. Mean visual analogue scale (VAS) pain intensity (0-10) reduced from 8.6 to 1.7 (p < 0.001). Good or excellent results were achieved in 26 patients, while two patients reported fair and another two poor results. Complete osseous fusion was observed at a mean of 10.9 weeks (8-13) postoperatively.


CONCLUSIONS
For the treatment of talonavicular arthritis, the application of mono- and multidirectional angle-stable mini-plates provided a strong fixation that led to high union rates and good to excellent overall outcome.
Department of Orthopaedic Surgery, University of Regensburg, Bad Abbach, Germany. lechler@med.uni-marburg.de
Philipp
P
Lechler
Stephanie
S
Graf
Franz Xaver
FX
Köck
Jens
J
Schaumburger
Joachim
J
Grifka
Martin
M
Handel
D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods*; D001860:Bone Plates; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011446:Prospective Studies; D011859:Radiography; D012189:Retrospective Studies; D013628:Talus / Q000000981:diagnostic imaging / Q000601:surgery; D013640:Tarsal Joints / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome