Skip to main content

Advertisement

Log in

Arthrodesis of the talonavicular joint using angle-stable mini-plates: a prospective study

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

Purpose

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Ledoux WR, Sangeorzan BJ (2004) Clinical biomechanics of the peritalar joint. Foot Ankle Clin 9:663–683

    Article  PubMed  Google Scholar 

  2. Wulker N, Stukenborg C, Savory KM, Alfke D (2000) Hindfoot motion after isolated and combined arthrodeses: measurements in anatomic specimens. Foot Ankle Int 21:921–927

    PubMed  CAS  Google Scholar 

  3. Crevoisier X (2011) The isolated talonavicular arthrodesis. Foot Ankle Clin 16:49–59

    Article  PubMed  Google Scholar 

  4. Easley ME, Trnka HJ, Schon LC, Myerson MS (2000) Isolated subtalar arthrodesis. J Bone Joint Surg Am 82:613–624

    PubMed  CAS  Google Scholar 

  5. Plaass C, Knupp M, Barg A, Hintermann B (2009) Anterior double plating for rigid fixation of isolated tibiotalar arthrodesis. Foot Ankle Int 30:631–639

    Article  PubMed  Google Scholar 

  6. Strauss EJ, Schwarzkopf R, Kummer F, Egol KA (2008) The current status of locked plating: the good, the bad, and the ugly. J Orthop Trauma 22:479–486

    Article  PubMed  Google Scholar 

  7. Button G, Pinney S (2004) A meta-analysis of outcome rating scales in foot and ankle surgery: is there a valid, reliable, and responsive system? Foot Ankle Int 25:521–525

    PubMed  Google Scholar 

  8. Soren A, Waugh TR (1980) The historical evolution of arthrodesis of the foot. Int Orthop 4:3–11

    Article  PubMed  CAS  Google Scholar 

  9. Zwipp H, Rammelt S, Endres T, Heineck J (2010) High union rates and function scores at midterm followup with ankle arthrodesis using a four screw technique. Clin Orthop Relat Res 468:958–968

    Article  PubMed  Google Scholar 

  10. Rammelt S, Marti RK, Zwipp H (2006) Arthrodesis of the talonavicular joint. Orthopade 35(4):428–434

    Article  PubMed  CAS  Google Scholar 

  11. Popelka S, Hromádka R, Vavrík P, Stursa P, Pokorný D, Jahoda D, Sosna A (2010) Isolated talonavicular arthrodesis in patients with rheumatoid arthritis of the foot and tibialis posterior tendon dysfunction. BMC Musculoskelet Disord 11:38

    Article  PubMed  Google Scholar 

  12. Jarrell SE 3rd, Owen JR, Wayne JS, Adelaar RS (2009) Biomechanical comparison of screw versus plate/screw construct for talonavicular fusion. Foot Ankle Int 30:150–156

    Article  PubMed  Google Scholar 

  13. DeVries JG, Granata JD, Hyer CF (2011) Fixation of first tarsometatarsal arthrodesis: a retrospective comparative cohort of two techniques. Foot Ankle Int 32:158–162

    Article  PubMed  Google Scholar 

  14. Scranton PE, Coetzee JC, Carreira D (2009) Arthrodesis of the first metatarsocuneiform joint: a comparative study of fixation methods. Foot Ankle Int 30:341–345

    Article  PubMed  Google Scholar 

  15. de Moraes Barros Fucs PM, Svartman C, de Assumpção RM, Yamada HH, Simis SD (2012) Surgical technique: medial column arthrodesis in rigid spastic planovalgus feet. Clin Orthop Relat Res 470:1334–1343

    Article  PubMed  Google Scholar 

  16. Diezi C, Favre P, Vienne P (2008) Primary isolated subtalar arthrodesis: outcome after 2 to 5 years followup. Foot Ankle Int 29:1195–1202

    Article  PubMed  Google Scholar 

  17. Chen CH, Huang PJ, Chen TB, Cheng YM, Lin SY, Chiang HC, Chen LC (2001) Isolated talonavicular arthrodesis for talonavicular arthritis. Foot Ankle Int 22:633–636

    PubMed  CAS  Google Scholar 

  18. Harper MC (1999) Talonavicular arthrodesis for the acquired flatfoot in the adult. Clin Orthop Relat Res 365:65–68

    Article  PubMed  Google Scholar 

  19. Papa J, Myerson M, Girard P (1993) Salvage, with arthrodesis, in intractable diabetic neuropathic arthropathy of the foot and ankle. J Bone Joint Surg Am 75:1056–1066

    PubMed  CAS  Google Scholar 

  20. Harper MC, Tisdel CL (1996) Talonavicular arthrodesis for the painful adult acquired flatfoot. Foot Ankle Int 17:658–661

    PubMed  CAS  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Philipp Lechler.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lechler, P., Graf, S., Köck, F.X. et al. Arthrodesis of the talonavicular joint using angle-stable mini-plates: a prospective study. International Orthopaedics (SICOT) 36, 2491–2494 (2012). https://doi.org/10.1007/s00264-012-1670-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-012-1670-y

Keywords

Navigation