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Hoke triple arthrodesis

J W Duncan, W W Lovell

    The Journal of Bone and Joint Surgery. American Volume
    |September 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    The Hoke triple arthrodesis effectively corrects foot deformities with acceptable non-union rates. A modified surgical technique significantly reduced aseptic necrosis of the talus, a previously noted complication.

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    Area of Science:

    • Orthopedic surgery
    • Foot and ankle reconstruction

    Background:

    • The Hoke triple arthrodesis is a surgical procedure for foot and ankle deformities.
    • Previous studies reported complications such as aseptic necrosis of the talus and potential ankle joint stress.

    Purpose of the Study:

    • To review the outcomes of 109 Hoke triple arthrodesis procedures performed between 1945 and 1974.
    • To evaluate the effectiveness of a modified surgical technique in preventing aseptic necrosis of the talus.

    Main Methods:

    • Retrospective review of 109 Hoke triple arthrodesis cases.
    • Analysis of complication rates, including non-union and aseptic necrosis.
    • Assessment of long-term ankle joint stress and degeneration, particularly in patients with myelomeningocele.

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    Main Results:

    • The procedure demonstrated efficacy in deformity correction and had comparable non-union rates to other series.
    • An overall incidence of 6.5% for aseptic necrosis of the talus was observed.
    • A modified technique preserving the artery to the tarsal canal eliminated aseptic necrosis complications.
    • Excessive ankle joint stress was not a significant issue during follow-up.
    • Fourteen patients with myelomeningocele showed accelerated ankle joint degeneration but no Charcot joint development.

    Conclusions:

    • The Hoke triple arthrodesis is a reliable procedure for foot and ankle deformity correction.
    • A modified surgical technique effectively prevents aseptic necrosis of the talus.
    • Long-term ankle joint stress is not a significant concern, though degeneration may accelerate in specific patient populations like those with myelomeningocele.