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Arthrodesis of the navicular
1Orthopaedic Foot & Ankle Service, Cooper University Hospital, 3 Cooper Plaza, Suite 411, Camden, NJ 08103, USA. castro-michael@cooperhealth.edu
Foot and Ankle Clinics
|April 6, 2004
Summary
Arthrodesis of the navicular complex restores the medial column for pain relief and function. This surgical option is effective for specific degenerative conditions when combined with hindfoot correction.
Area of Science:
- Orthopedic surgery
- Foot and ankle reconstruction
Background:
- Degenerative changes in the navicular complex can lead to pain and dysfunction.
- Isolated arthrodesis of the navicular complex aims to restore medial column integrity.
Purpose of the Study:
- To evaluate the role of isolated navicular complex arthrodesis in managing degenerative joint disease.
- To define criteria for successful surgical intervention and outcomes.
Main Methods:
- Surgical fusion of the talonavicular-naviculocuneiform joints (navicular complex).
- Inclusion of concomitant hindfoot correction.
- Use of cancellous or structural grafting for bone loss or necrosis.
- Excision of navicular remnants and talocuneiform fusion if nonunion risk is high.
Main Results:
- Restoration of medial column integrity leads to pain relief and improved function.
- Successful management is achievable for Grade III posterior tibial tendon insufficiency (PTTI) with limited degenerative changes.
- Grafting techniques can address osseous necrosis or bone loss, maintaining medial column length.
Conclusions:
- Isolated navicular complex arthrodesis is a viable treatment for specific degenerative conditions.
- Meticulous restoration of the medial column and consideration of adjacent joint alignment are crucial for optimal outcomes.