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Novel Triple-Loop Technique for Suturing TFCC Injuries without Transosseous Tunnel
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Comparative Nonunion Rates in Triple Arthrodesis.

Lindsey J Klassen1, Eric Shi2, Glenn M Weinraub3

  • 1Attending Physician, Kaiser Permanente South San Francisco, South San Francisco, CA.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|September 27, 2018
PubMed
Summary
This summary is machine-generated.

The talonavicular joint is most prone to nonunion after foot triple arthrodesis. Effective joint preparation involves resection or curettage combined with fish scaling for optimal osseous union.

Keywords:
fusionnonuniontriple arthrodesis

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Area of Science:

  • Orthopedic Surgery
  • Foot and Ankle Reconstruction
  • Surgical Outcomes Research

Background:

  • Triple arthrodesis is a common procedure for severe foot deformities.
  • Uncertainty exists regarding which specific joint is most susceptible to nonunion.
  • Optimal joint preparation techniques for successful fusion remain debated.

Purpose of the Study:

  • To identify the joint at highest risk for nonunion following triple arthrodesis.
  • To evaluate the efficacy of different joint preparation methods on osseous union.
  • To provide evidence-based recommendations for improving triple arthrodesis outcomes.

Main Methods:

  • Retrospective radiographic review of 157 primary triple arthrodesis procedures (2007-2013).
  • Data collection on joint preparation techniques (resection, curettage, fish scaling).
  • Postoperative imaging analysis to determine time to osseous union and nonunion rates per joint.

Main Results:

  • Overall nonunion rate was 29.9% (47/157).
  • Talonavicular joint nonunion rate: 20.4% (32/157).
  • Calcaneocuboid joint nonunion rate: 17.2% (27/157).
  • Subtalar joint nonunion rate: 8.9% (14/157).
  • Combination of joint resection/curettage with fish scaling showed efficacy.

Conclusions:

  • The talonavicular joint presents the highest risk for nonunion in triple arthrodesis.
  • A combined joint preparation technique involving resection or curettage with fish scaling is most effective.
  • Findings can guide surgical technique to improve fusion rates in triple arthrodesis.