Talonavicular arthrodesis: Does the IOFiX system provide safe and reliable fixation?

Area of Science:

• Orthopedic surgery
• Podiatric medicine
• Biomedical engineering

Background:

• Talonavicular (TN) arthrodesis is a surgical procedure to treat arthritis in the TN joint, often part of a triple fusion for foot reconstruction.
• Traditional arthrodesis methods have variable success rates, necessitating evaluation of alternative techniques.
• The IOFiX system is a newer approach for TN fusion, requiring assessment of its clinical efficacy.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of TN fusion using the IOFiX system.
• To determine the union rate and re-operation rate for patients undergoing TN fusion with IOFiX.
• To compare outcomes of isolated TN fusion versus TN fusion as part of a triple fusion.

Main Methods:

• Retrospective analysis of patients who underwent TN fusion with the IOFiX system between 2012 and 2019.
• Inclusion criteria: age over 16, at least one year post-operation.
• Data collected included patient demographics, union rates, and re-operation rates.

Main Results:

• 35 patients were analyzed, with osteoarthritis being the most common indication (n=19).
• The union rate was 91% (3/35) by one year, and 14% (5/35) of patients required re-operation.
• Re-operations were primarily for hardware removal (4/5) or non-union (1/5). Bone graft use did not impact complication rates.

Conclusions:

• The IOFiX system appears to be a reliable alternative for TN fusion.
• TN fusion as part of a triple fusion showed a trend towards lower non-union rates, though not statistically significant.
• Further investigation is warranted to confirm the significance of improved outcomes in triple fusions compared to isolated TN fusions.