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Subtalar and Naviculocuneiform Arthrodesis for the Treatment of Hindfoot Valgus With Collapse of the Medial Arch

Gilgen, Andrea MD; Knupp, Markus MD; Hintermann, Beat MD

Techniques in Foot & Ankle Surgery: December 2013 - Volume 12 - Issue 4 - p 190–195
doi: 10.1097/BTF.0b013e31829f0dde
Techniques

In many cases of acquired flatfoot deformity, the sagging of the joint line originates in the naviculocuneiform joint with collapse of the medial arch. Posterior tibial tendon function may or may not be preserved. The commonly held treatment option with triple or double arthrodesis fails to address the instability of the naviculocuneiform joint. To achieve a stable correction of the deformity, the authors, therefore, started to combine an arthrodesis of the subtalar joint with a fusion of the naviculocuneiform joint. In case of residual valgus malalignment after preliminary correction, a medial sliding osteotomy of the calcaneus is necessary to achieve full correction of the hindfoot. Sparing the Chopart joint may enable the foot to accommodate better to the ground while walking, particularly on uneven ground. Despite excellent short-term results, longer term outcome studies are necessary to validate the benefit of this technique.

Clinic of Orthopeadic Surgery, Kantonsspital Baselland, Liestal, Switzerland

The authors declare no conflict of interest.

Address correspondence and reprint requests to Beat Hintermann, MD, Clinic of Orthopeadic Surgery, Kantonsspital Baselland, Rheinstrasse 26, Liestal CH-4410, Switzerland. E-mail: beat.hintermann@ksbl.ch.

© 2013 by Lippincott Williams & Wilkins