Single-incision lateral approach for triple arthrodesis.

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Surgical Technique Innovation

Background:

• Triple arthrodesis is a key hindfoot corrective surgery fusing talonavicular, calcaneocuboid, and subtalar joints.
• Established approaches include double-incision and single-incision medial techniques.
• This study introduces and evaluates a single-incision lateral approach.

Purpose of the Study:

• To present the outcomes of a single-incision lateral approach for triple arthrodesis.
• To compare this novel technique with a double-incision approach.
• To assess deformity correction, union rates, surgical time, and complications.

Main Methods:

• Retrospective review of 70 patients undergoing triple arthrodesis (2007-2011).
• Comparison between double-incision (n=33) and single-incision lateral (n=37) groups.
• Analysis of deformity correction, union rates, operative time, complications, wound healing, reoperations, and VAS pain scores.

Main Results:

• No significant differences in deformity correction, wound healing, complications, reoperations, or VAS pain improvement.
• Single-incision lateral approach demonstrated a significantly shorter operative time (86 vs 95 minutes, P=.0395).
• Union rates for talonavicular and subtalar joints were comparable; five patients had calcaneocuboid joint nonunions across both groups.

Conclusions:

• This is the first study reporting outcomes for a single lateral approach to triple arthrodesis.
• The single-incision lateral technique is faster than the double-incision method.
• Low symptomatic nonunion rates suggest calcaneocuboid joint fusion may not be critical for symptomatic relief or deformity correction.