Radiographic correction of medial-column malalignment after minimally invasive versus open talonavicular arthrodesis: A single-centre comparative cohort study.

BACKGROUND: Talonavicular (TN) arthrodesis can be performed open or minimally invasively (MIS); whether MIS reproduces the radiographic medial-column re-alignment of open surgery remains unclear.

METHODS: Retrospective cohort of 56 feet (32 MIS, 24 open) treated 2021-2025. Co-primary endpoints: absolute talo-first metatarsal (Meary) angle in dorsoplantar (DP) and lateral (LAT) projections, and radiographic union.

RESULTS: Absolute Meary angle decreased significantly in both groups (all p < 0.001). Open feet had greater preoperative malalignment (DP 14.8° vs 10.8°, p = 0.019). Postoperative angles did not differ significantly (DP 0.92° vs 1.96°, p = 0.091; LAT 1.38° vs 2.53°, p = 0.073); 32/32 (100%) MIS and 21/24 (87.5%) open feet reached ±5° physiological range (DP, p = 0.073). Union: 32/32 (100%) MIS, 23/24 (95.8%) open.

CONCLUSIONS: MIS and open TN arthrodesis achieved comparable medial-column re-alignment and union rates, despite greater baseline deformity in the open cohort, complementing previously reported comparable functional outcomes.

LEVEL OF EVIDENCE: III, retrospective comparative cohort study.