TRIPLE ARTHRODESIS USING INTERNAL-FIXATION IN TREATMENT OF ADULT FOOTDISORDERS

Forty adult patients with 44 fused feet were evaluated at an average o f 4.9 years after triple arthrodesis. The average age of the patients at operation was 41 years. All operations were performed by a specific technique using rigid internal fixation with screws. Outcome was grad ed using the clinical criteria of Hallgrimsson as modified by Angus an d Cowell. Function was evaluated according to modified Arthritis Impac t Measurement Scales (AIMS). Radiographic evaluation included measurem ent of lateral talocalcaneal angle, lateral talometatarsal angle, and anteroposterior (AP) talometatarsal angle on standing or simulated wei ght-bearing radiographs. Thirty-four feet had good results, six had fa ir results, and there were four failures. The average patient could fu nction painlessly on flat surfaces in nonstrenuous activities and had only occasional mild pain with more vigorous activities. In roentgenog raphic parameters, there was an average improvement of 17-degrees in t he lateral talometatarsal angle, 11-degrees improvement in the lateral talocalcaneal angle, and an improvement of 18-degrees in the AP talom etatarsal angle. There were two pseudarthroses, no recurrences, and tw o unsatisfactory corrections. When carefully done, triple arthrodesis can restore an adult patient with a disabling foot disorder to normal function and minimal pain.