Double versus Triple Arthrodesis for Flatfoot Deformity: When, Why, and How?

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Surgery
• Biomechanics

Background:

• Arthrodesis is a historical surgical technique for correcting flatfoot deformity.
• Rearfoot arthrodesis offers effective deformity correction and long-term stability.
• Recent discussions question the necessity of calcaneocuboid joint inclusion in traditional triple arthrodesis.

Purpose of the Study:

• To compare double arthrodesis (talonavicular and subtalar joints) with traditional triple arthrodesis (including calcaneocuboid joint).
• To provide a comprehensive review to help surgeons choose between these flatfoot correction procedures.

Main Methods:

• Review of biomechanics of rearfoot and midfoot joints.
• Analysis of surgical approaches for double and triple arthrodesis.
• Evaluation of fixation techniques used in both procedures.
• Synthesis of recent literature outcomes for both surgical options.

Main Results:

• The review details the biomechanical principles underlying each procedure.
• It outlines various surgical approaches and fixation methods.
• Recent literature outcomes comparing the two techniques are presented.

Conclusions:

• Both double and triple arthrodesis are viable options for flatfoot correction.
• The choice between procedures depends on specific patient factors and surgeon preference.
• Further research may clarify optimal indications for each technique.