Limited intertarsal arthrodesis using bone grafting and pin fixation

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Bone Grafting Techniques

Background:

• Post-traumatic and primary degenerative arthritis commonly affect intertarsal articulations.
• Limited mobility and pain significantly impair foot function in affected patients.
• Surgical fusion aims to alleviate pain and restore function in arthritic joints.

Purpose of the Study:

• To evaluate the functional and subjective outcomes of iliac crest bone grafting and K wire fixation for arthritic intertarsal joint fusion.
• To compare the efficacy of this surgical technique with previously published methods.
• To identify factors influencing surgical outcomes.

Main Methods:

• Sixteen patients with arthritic intertarsal joints underwent fusion using iliac crest bone graft and K wire fixation.
• Pre- and post-operative assessments included the American Orthopaedic Foot & Ankle Society (AOFAS) scores and Foot Function Index (FFI).
• A subjective scoring system was employed to gauge patient satisfaction and perceived outcomes.

Main Results:

• Significant improvements were observed in AOFAS scores (average 41-point increase) and FFI (decrease from 64 to 24).
• 81% of patients reported good or excellent subjective outcomes.
• Fusion of the 4th and 5th tarsometatarsal (TMT) joints correlated with poorer functional scores, and worker's compensation claims were associated with lower subjective satisfaction.

Conclusions:

• Iliac crest bone grafting with K wire fixation provides effective fusion for arthritic intertarsal joints, leading to substantial functional improvement and high patient satisfaction.
• The technique yields results comparable to other surgical fusion methods.
• Careful consideration of TMT joint involvement and patient compensation status is warranted when predicting outcomes.