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  • Title: [Stabilization of the hindfoot by talonavicular arthrodesis. Results apropos of 50 cases].
    Author: Asencio G, Roeland A, Megy B, Bertin R, Fouque E, Leclerc V.
    Journal: Rev Chir Orthop Reparatrice Appar Mot; 1995; 81(8):691-701. PubMed ID: 8761650.
    Abstract:
    UNLABELLED: Hindfoot stabilization can be obtained by an isolated talonavicular arthrodesis as well as a triple arthrodesis. MATERIAL: There were 27 cases of unstable neurological foot, 13 cases of Rhumatoid foot, 7 cases of flat feet and 3 cases of post-trauma arthritis of the talonavicular joint. The procedure was, in all cases, a talonavicular arthrodesis, associated in some cases to a lengthening of the Achilles tendon, tendon transfer and forefoot correction. METHOD: 50 cases were reviewed with a mean follow-up of 40 months. RESULTS: There were 18 per cent cases of non-union. This could be explained by 2 technical errors: bad cartilagenous resection of the surfaces and unstable bone fixation. No subtalar mobility was noted in all cases. Only one case had a midtarsal mobility associated to a non-union. 39 feet had a normal heel axation. In most cases functional improvement was significant with a painless gait. DISCUSSION: Hindfoot stabilization can be obtained by an isolated talonavicular arthrodesis. Non-union could be avoided by a better surgical technique and a cast immobilization of 2 and a half months. The pre-operative deformities should be reduced manually, because isolated fixed valgus and varus can not be corrected by an isolated talonavicular arthrodesis. In conclusion, the indications are: An early valgus deformity of the hindfoot in rhumatoid arthritis. The aim is to avoid a fixed valgus deformity. Neurological induced equino varus deformities specially after stroke and other reducible neurological deformities. Flat foot due to posterior tibialis insufficiency. Isolated arthritis of the talonavicular joint.
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