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Single-incision lateral approach for triple arthrodesis.
Foot Ankle Int. 2014 Sep; 35(9):896-902.FA

Abstract

BACKGROUND

Triple arthrodesis is a powerful hindfoot corrective procedure involving fusion of the talonavicular (TN), calcaneocuboid (CC), and subtalar (ST) joints. A 2-incision approach, a single-incision medial triple arthrodesis, and a single-incision medial double arthrodesis are well described. We present a single-incision lateral approach to triple arthrodesis.

METHODS

We retrospectively reviewed 70 patients who underwent triple arthrodesis at our institution from 2007 to 2011. Patients had either double-incision (n = 33) or single-incision lateral (n = 37) triple arthrodesis. A single surgeon performed all procedures. The most common diagnosis was stage III planovalgus deformity. Deformity correction, union rate, time of surgery, complications, wound healing, reoperations, and pre- and postoperative visual analog scale (VAS) pain scores were analyzed for both groups.

RESULTS

There were no statistical differences in deformity correction, wound healing, complications, reoperations, or improvement in VAS pain scores. Operation time was significantly shorter in the single-incision lateral group (86 minutes vs 95 minutes, P = .0395). There was no difference in union rates with regard to the TN, ST, or CC joints. Five patients had radiographic nonunions of the CC joint between both groups.

CONCLUSIONS

This is the first study that presents outcomes of a single lateral approach for triple arthrodesis. The single-incision approach was faster. The low rate of symptomatic nonunions suggests that fusion of the CC joint may not be important in symptomatic relief or deformity correction.

LEVEL OF EVIDENCE

Level III, retrospective comparative study.

Authors+Show Affiliations

Geisinger Medical Center, Danville, PA, USA bemooremd@gmail.com.Geisinger Medical Center, Danville, PA, USA.Geisinger Medical Center, Danville, PA, USA.University of Utah Health Care, Salt Lake City, UT, USA.Geisinger Medical Center, Danville, PA, USA.

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

25005551

Citation

Moore, Blake E., et al. "Single-incision Lateral Approach for Triple Arthrodesis." Foot & Ankle International, vol. 35, no. 9, 2014, pp. 896-902.
Moore BE, Wingert NC, Irgit KS, et al. Single-incision lateral approach for triple arthrodesis. Foot Ankle Int. 2014;35(9):896-902.
Moore, B. E., Wingert, N. C., Irgit, K. S., Gaffney, C. J., & Cush, G. J. (2014). Single-incision lateral approach for triple arthrodesis. Foot & Ankle International, 35(9), 896-902. https://doi.org/10.1177/1071100714539658
Moore BE, et al. Single-incision Lateral Approach for Triple Arthrodesis. Foot Ankle Int. 2014;35(9):896-902. PubMed PMID: 25005551.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Single-incision lateral approach for triple arthrodesis. AU - Moore,Blake E, AU - Wingert,Nathaniel C, AU - Irgit,Kaan S, AU - Gaffney,Christian J, AU - Cush,Gerard J, Y1 - 2014/07/08/ PY - 2014/7/10/entrez PY - 2014/7/10/pubmed PY - 2015/5/13/medline KW - flatfoot deformity KW - pes planovalgus KW - tibialis posterior tendon dysfunction KW - triple arthrodesis SP - 896 EP - 902 JF - Foot & ankle international JO - Foot Ankle Int VL - 35 IS - 9 N2 - BACKGROUND: Triple arthrodesis is a powerful hindfoot corrective procedure involving fusion of the talonavicular (TN), calcaneocuboid (CC), and subtalar (ST) joints. A 2-incision approach, a single-incision medial triple arthrodesis, and a single-incision medial double arthrodesis are well described. We present a single-incision lateral approach to triple arthrodesis. METHODS: We retrospectively reviewed 70 patients who underwent triple arthrodesis at our institution from 2007 to 2011. Patients had either double-incision (n = 33) or single-incision lateral (n = 37) triple arthrodesis. A single surgeon performed all procedures. The most common diagnosis was stage III planovalgus deformity. Deformity correction, union rate, time of surgery, complications, wound healing, reoperations, and pre- and postoperative visual analog scale (VAS) pain scores were analyzed for both groups. RESULTS: There were no statistical differences in deformity correction, wound healing, complications, reoperations, or improvement in VAS pain scores. Operation time was significantly shorter in the single-incision lateral group (86 minutes vs 95 minutes, P = .0395). There was no difference in union rates with regard to the TN, ST, or CC joints. Five patients had radiographic nonunions of the CC joint between both groups. CONCLUSIONS: This is the first study that presents outcomes of a single lateral approach for triple arthrodesis. The single-incision approach was faster. The low rate of symptomatic nonunions suggests that fusion of the CC joint may not be important in symptomatic relief or deformity correction. LEVEL OF EVIDENCE: Level III, retrospective comparative study. SN - 1944-7876 UR - https://www.unboundmedicine.com/medline/citation/25005551/Single_incision_lateral_approach_for_triple_arthrodesis_ L2 - http://journals.sagepub.com/doi/full/10.1177/1071100714539658?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -