Different faces of the triple arthrodesis

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction

Background:

• Severe pes planovalgus and cavovarus foot deformities often necessitate surgical intervention when conservative treatments fail.
• Triple arthrodesis is a common procedure for these complex deformities.

Purpose of the Study:

• To evaluate the efficacy of modified triple arthrodesis with extended bone wedge resections for correcting severe foot deformities.
• To achieve a plantigrade, less painful foot with improved function.

Main Methods:

• Modification of the standard triple arthrodesis procedure.
• Inclusion of extended bone wedge resections.
• Application of additional hindfoot or midfoot osteotomies (Japas, Cole, Jahss) as needed.
• Correction of residual hindfoot valgus with medial displacement calcaneal osteotomy.
• Correction of residual hindfoot varus with lateral closing wedge calcaneal osteotomy.

Main Results:

• The modified triple arthrodesis allows for improved correction of severe pes planovalgus and cavovarus deformities.
• Specific osteotomies effectively address midfoot/forefoot cavus and residual hindfoot alignment issues.
• Lateral closing wedge calcaneal osteotomy provides adequate correction for hindfoot varus without bone grafting or extensive medial incisions.

Conclusions:

• Modified triple arthrodesis with extended bone resections and targeted osteotomies is an effective reconstructive procedure for severe foot deformities.
• This approach yields good functional outcomes and pain reduction.