Isolated talonavicular joint arthrodesis through minimal incision surgery

Carranza-Bencano, Andrés; Tejero, Sergio; Torres, J.J. Fernández; Castillo-Blanco, G. del; Alegrete-Parra, Andrés

doi:10.1016/j.fas.2014.11.003

Cited by 10 publications

(10 citation statements)

References 26 publications

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“…In this study, the postoperative AOFAS score increased significantly, which is similar to the results reported by Lu CK and Shymon et al [1, 9, 10]. All patients were reported to obtain significant pain relief and improved overall function according to VAS score.…”

Section: Discussionsupporting

confidence: 90%

“…It is worthy to note that our fusion rates were as high as 100% without any interface screws loosening. Besides, Carranza-Bencano A et al [10] found that 10 ~ 33% of the patients who underwent TNA developed adjacent joint degeneration. In our study, 1.45% of cases required antibiotics for wound infection, and 4.35% of cases suffered from adjacent arthritis without other complications.…”

Section: Discussionmentioning

confidence: 99%

“…One to three screws have commonly been used to fix TN interface [2, 10]. One screw alone cannot prevent interface rotation.…”

Section: Discussionmentioning

confidence: 99%

“…All patients were assessed by clinical examinations: (1) imaging assessments: the standing AP and lateral total foot X-rays to evaluate the radiological fusion that callus passed through the TN interspace or if the interspace was disappeared; (2) functional outcome assessments: the American Orthopaedic Foot & Ankle Society hindfoot score (AOFAS), the visual analogue scale (VAS) score to evaluate postoperative recovery [1–3, 9, 10]; (3) postoperative complication assessments: the incidence rates of complications to evaluate the side effects, the satisfaction scores [15] regarding pain relief, activities of daily living, and return to recreational activities.…”

Section: Methodsmentioning

confidence: 99%

“…Staples and plates are both eccentric fixation with potential disadvantages of extensive soft tissue dissection and impaired blood supply [4, 5, 9]. Screws are most commonly used to fuse TN without above drawback [3, 5, 10, 11]. Different screw designs affect compressive force and fusion rates.…”

Section: Introductionmentioning

confidence: 99%

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Individual headless compression screws fixed with three-dimensional image processing technology improves fusion rates of isolated talonavicular arthrodesis

et al. 2017

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BackgroundScrew fixation is a typical technique for isolated talonavicular arthrodesis (TNA), however, no consensus has been reached on how to select most suitable inserted position and direction. The study aimed to present a new fixation technique and to evaluate the clinical outcome of individual headless compression screws (HCSs) applied with three-dimensional (3D) image processing technology to isolated TNA.MethodsFrom 2007 to 2014, 69 patients underwent isolated TNA by using double Acutrak HCSs. The preoperative three-dimensional (3D) insertion model of double HCSs was applied by Mimics, Catia, and SolidWorks reconstruction software. One HCS oriented antegradely from the edge of dorsal navicular tail where intersected interspace between the first and the second cuneiform into the talus body along the talus axis, and the other one paralleled the first screw oriented from the dorsal-medial navicular where intersected at the medial plane of the first cuneiform. The anteroposterior and lateral X-ray examinations certified that the double HCSs were placed along the longitudinal axis of the talus. Postoperative assessment included the American Orthopaedic Foot & Ankle Society hindfoot (AOFAS), the visual analogue scale (VAS) score, satisfaction score, imaging assessments, and complications.ResultsAt the mean 44-months follow-up, all patients exhibited good articular congruity and solid bone fusion at an average of 11.26 ± 0.85 weeks (range, 10 ~ 13 weeks) without screw loosening, shifting, or breakage. The overall fusion rates were 100%. The average AOFAS score increased from 46.62 ± 4.6 (range, 37 ~ 56) preoperatively to 74.77 ± 5.4 (range, 64–88) at the final follow-up (95% CI: −30.86 ~ −27.34; p < 0.001). The mean VAS score decreased from 7.01 ± 1.2 (range, 4 ~ 9) to 1.93 ± 1.3 (range, 0 ~ 4) (95% CI: 4.69 ~ 5.48; p < 0.001). One cases (1.45%) and three cases (4.35%) experienced wound infection and adjacent arthritis respectively. The postoperative satisfaction score including pain relief, activities of daily living, and return to recreational activities were good to excellent in 62 (89.9%) cases.ConclusionsIndividual 3D reconstruction of HCSs insertion model can be designed with three-dimensional image processing technology in TNA. The technology is safe, effective, and reliable to isolated TNA method with high bone fusion rates, low incidences of complications.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

“…One to three screws have commonly been used to fix TN interface [2, 10]. One screw alone cannot prevent interface rotation.…”

Section: Discussionmentioning

confidence: 99%