High CT-scan confirmed union rates following subtalar and talonavicular arthrodesis through a single medial approach.

BACKGROUND: Subtalar (ST) and talonavicular (TN) arthrodesis through a single medial approach is an established technique when dealing with common hindfoot conditions, but evidence of arthrodesis union usually relies on plain radiographs evaluation. The aims of this study were to determine long-term clinical and radiographic outcomes, including computed tomography scan (CT-scan) confirmed union rates, of ST and TN arthrodesis through a single medial approach.

METHODS: A retrospective cohort study was performed on 36 patients who underwent ST and TN arthrodesis through a single medial approach. Patient satisfaction was assessed as "very satisfied", "satisfied" and "unsatisfied". Clinical evaluation was performed using the Visual Analog Scale (VAS-P) and the Foot and Ankle Outcome Score (FAOS). Radiographic assessment included postoperative CT-scan evaluation to confirm union rates.

RESULTS: The mean follow-up was 43 (range, 20-86) months. We registered 30 "very satisfied" patients (83.3%), 5 "satisfied" patients (13.9%) and 1 "unsatisfied" patient (2.8%), as well as statistically significant improvement on both clinical scores tested (p < .05). CT-scan evaluation confirmed fusion of both TN and ST joints on 32 cases (88.9%), TN joint non-union on 4 cases (11.1%) and ST arthrodesis on 36 cases (100%).

CONCLUSION: ST and TN arthrodesis through a single medial approach provide statistically significant clinical and radiographic improvements, as well as CT-scan confirmed high union-rates.

LEVEL OF CLINICAL EVIDENCE: Level III, retrospective cohort study.