Efficiency of locking-plate fixation in isolated talonavicular fusion

Introdution: Talonavicular (TN) fusion is an effective means of treating hindfoot deformity and pain. At the cost of a certain limited morbidity, it allows lasting stabilization of all of the torque joints. Nonunion rates, however, are high, due to insufficient mechanical stability of the fixation. The present study assessed radiological and clinical results in TN fusion fixed by two retrograde compression screws and a dorsal locking plate. Material and method: A retrospective single-surgeon study recruited 26 TN fusions performed in 25 patients (13 male, 12 female; mean age, 54.6 +/- 15.4 years) between March 1st, 2010 and February 28th, 2014. Mean follow-up was 14.9 +/- 8.7 months. Bone fusion and anatomic results were assessed on dorsoplantar, lateral and Meary weight-bearing radiographs. Results: Radiologic fusion was achieved in all cases, at a mean 2.7 +/- 0.7 months. Mean TN coverage angle was 21.7 +/- 10.5 degrees preoperatively and 3.8 +/- 1.8 degrees at follow-up. Mean AOFAS score improved significantly, from 37.2 +/- 11.8 (range, 20-53) preoperatively to 79.4 +/- 11.4 (range, 45-98) at follow-up. Conclusion: TN fusion fixed by two retrograde compression screws and a dorsal locking plate provided a high rate of consolidation without loss of angular correction and with satisfactory clinical results. Type of study: Retrospective. (C) 2016 Elsevier Masson SAS. All rights reserved.