Arthrodesis of the talocalcaneal joint in adults. Indications, procedure, outcome

Affections of the rearfoot-comp[ex may occur because of various etiologies and show differing pathogenetic patterns. Besides posttraumatic changes, th e rheumatoid arthritis, primary disorders and neurologic complications are registered. Biomechanically the hindfoot-complex is characterised by the jo int play of ligamentous, bony and tendineal structures. Referring to diagno stics the clinical and radiologic examination are predominant. In the liter ature there is no uniform opinion concerning the therapeutic algorythm. The arthrodesis as a surgical procedure is commonly used, nevertheless importa nt differences may be stated with regard to the choice of the osteosynthesi s or the number of the joints to be fused. We present biomechanical models, diagnostic examinations and operative procedures in this context. Our own results of patients who underwent sugical interventions involving joints of the lower rearfoot using the Kitaoka hindfoot-score are demonstrated.