Triple arthrodesis

Abstract

Pain, instability, and malalignment of the Chopart and subtalar joints, which in combination are termed the triple joint complex, can have a substantial impact on patients’ activities of daily living. Triple joint dysfunction can be caused by a variety of conditions including neuromuscular pathology, congenital conditions, degenerative disorders, or trauma. Nonetheless, this variety of pathologic conditions can often be addressed with triple arthrodesis if joint sparing procedures have failed or are not feasible. Triple arthrodesis entails fusion of the talonavicular, calcaneocuboid, and subtalar joints. Although classically approached via dual incisions, there are options for accomplishing this operation with a single incision from either a medial or lateral approach. The ultimate goal of surgery is a pain-free neutral hindfoot with a plantigrade and neutral forefoot. Balancing deformity correction and soft tissue concerns while obtaining optimal joint position and adequate fixation and compression is a challenging undertaking. Potential complications include wound problems, residual deformity, non-union, nerve injury, persistent pain, and adjacent joint arthrosis.