Arthrodesis of the talocalcaneal joint in adults. Indications, procedure, outcome

Affections of the rearfoot-complex may occur because of various etiologies and show differing pathogenetic patterns. Besides posttraumatic changes, the rheumatoid arthritis, primary disorders and neurologic complications are registered. Biomechanically the hindfoot-complex is characterised by the joint play of ligamentous, bony and tendineal structures. Referring to diagnostics the clinical and radiologic examination are predominant. In the literature there is no uniform opinion concerning the therapeutic algorythm. The arthrodesis as a surgical procedure is commonly used, nevertheless important differences may be stated with regard to the choice of the osteosynthesis or the number of the joints to be fused. We present biomechanical models, diagnostic examinations and operative procedures in this context. Our own results of patients who underwent sugical interventions involving joints of the lower rearfoot using the Kitaoka hindfoot-score are demonstrated.