Hindfoot arthrodesis in adults utilizing a dowel graft technique

Surgical fusion may be indicated to stabilize deformed or painful hindfoot joints. Although more commonly performed in children or adolescents, it is the salvage procedure available for adults. Twenty-six patients (30 feet; 20 women, six men) followed for an average of 44.1 months after hindfoot arthrodesis were investigated in a prospective study. Most (20 patients, 24 feet) had inflammatory arthritis, usually rheumatoid, two had previous fractures, and four patients had other diagnoses. All had fusions done using a dowel graft technique. Twenty-four patients (92%) were completely satisfied with the operation, one had mild reservations, and the one dissatisfied patient was a technical failure. All joints were fused utilizing clinical and roentgenographic evaluation. A detailed roentgenographic assessment indicated that the talometatarsal angle was the most effective measurement to assess the clinical deformity. Anteroposterior weight-bearing roentgenograms of the ankle were also important in evaluating these patients preoperatively and postoperatively. Postoperatively, only nine ankles appeared normal roentgenographically, while the others worsened, and four required ankle arthrodesis.