Triple arthrodesis

Correction of valgus hindfoot deformity can be successfully achieved with arthrodesis of the subtalar and talonavicular joints through a single medial based incision. The advantages of medial double arthrodesis compared with the standard triple arthrodesis 2-incision approach include the absence of a lateral incision and a few degrees of residual mobility through the unfused calcaneocuboid joint (CCJ). The CCJ has often been noted to distract and decompress with the abduction correction achieved through medial double fusion...

Hindfoot fusion is capable of correcting hindfoot deformities. Typically, this has been done through triple arthrodesis. Recently, there has been some discussion of a double arthrodesis, sparing the calcaneocuboid joint. We compared the radiographic corrective ability of these 2 fusion techniques. A retrospective radiographic review was performed of 20 consecutive triple arthrodeses (triple) and 20 consecutive talonavicular and subtalar arthrodesis with calcaneocuboid preservation (double). Additional midfoot arthrodesis or osteotomy was performed as needed in each group...

Triple arthrodesis is a powerful corrector of hindfoot deformity related to trauma, rheumatoid arthritis, and long-standing peritalar subluxation with posterior tibial tendon dysfunction. To avoid the common postoperative complications related to triple arthrodesis, one must be meticulous in preoperative evaluation as well as surgical technique. Presented are some tips and tricks to avoid the common complications and provide the patient with a plantigrade, stable foot, as well as some salvage options for triple arthrodesis in a malunited position...

BACKGROUND: Triple arthrodesis is a powerful hindfoot corrective procedure involving fusion of the talonavicular (TN), calcaneocuboid (CC), and subtalar (ST) joints. A 2-incision approach, a single-incision medial triple arthrodesis, and a single-incision medial double arthrodesis are well described. We present a single-incision lateral approach to triple arthrodesis. METHODS: We retrospectively reviewed 70 patients who underwent triple arthrodesis at our institution from 2007 to 2011...

Triple arthrodesis has traditionally been the procedure of choice for end-stage adult-acquired flatfoot. The results have been universally good, and it has proven to be dependable and predictable. Nonetheless, complications have been reported following triple arthrodesis in certain patients. Selective arthrodesis of the talonavicular joint and subtalar joint through a single medial approach has been developed as an alternative. The authors especially prefer this procedure with severe transverse plane deformity and often choose this approach as an alternative to triple arthrodesis in high-risk patients, including those patients with diabetes mellitus, rheumatoid arthritis, long-term steroid use, and the elderly...

The primary goal of triple arthrodesis for stage III and IV adult acquired flatfoot is to obtain a well-aligned plantigrade foot that will support the ankle in optimal alignment. Ancillary procedures including posterior muscle group lengthening, medial displacement calcaneal osteotomy, medial column stabilization, peroneus brevis tenotomy, or transfer and harvest of regional bone graft are often necessary to achieve adequate realignment. Image intensification is helpful in confirming optimal realignment before fixation...

While the medial double arthrodesis has gained significant popularity for hindfoot arthrodesis in recent years, much has been touted about the efficiency and cost savings of the procedure in comparison to its triple counterpart without any literature to reinforce this claim. The purpose of this retrospective study was to compare the hardware costs and operative time between the medial double and triple arthrodeses. A total of 276 patients (277 feet) were identified via CPT codes with 47 hindfoot cases (47 feet) meeting the inclusion criteria consisting of 21 medial double (6 males, 15 females) and 26 triple (8 males, 18 females) arthrodeses...

Management of the end-stage adult acquired flatfoot has historically been accomplished with a traditional two-incision triple arthrodesis. Although this procedure is well accepted, complications such as lateral wound dehiscence, nonunion, undercorrection, and residual deformity have been reported. The medial approach double arthrodesis is presented to offer the foot and ankle surgeon an alternative option to the long-standing, severe valgus foot. It has been the author's experience that the medial approach has fewer wound complications, higher union rates, and shorter operative and recovery times...