TALONAVICULAR ARTHRODESIS FOR THE PAINFUL ADULT ACQUIRED FLATFOOT

Twenty-seven consecutive patients with posterior tibial tendon insuffi ciency were treated with talonavicular arthrodesis as the primary stab ilizing procedure. Twenty-six patients were followed a minimum of 12 a nd an average of 27 months. Twenty-four patients had either no pain or pain only after heavy usage. Eleven patients were completely satisfie d with postoperative foot function, 13 were satisfied, with minor rese rvations, and 2 were satisfied, with major reservations. Results were rated as excellent in 10 patients, good in 14 patients, and fair in 2 patients. Successful arthrodesis was achieved in all patients, althoug h one patient required two additional bone grafts. Progressive arthros is in adjacent joints was noted in five patients, four of whom had art hrosis preoperatively. No deterioration of foot position was seen in a ny patient with follow-up as long as 5 years. An isolated talonavicula r arthrodesis seems to offer patients with this disorder both reliable pain improvement and lasting stability.