Combined autogenous iliac-crest bone-grafting and fixation with a pin or screw was used to achieve a fusion of the talocalcaneal joint in forty-one adults (forty-five arthrodeses). At a mean length of follow-up of fifty-seven months (range, thirty to ninety-six months), thirty-seven (90 per cent) of the patients were satisfied with the result. Objectively, the results were excellent after thirty-nine arthrodeses (87 per cent), good or fair after five (11 per cent), and poor after one (2 per cent). There was one non-union and one superficial wound infection. At the time of follow-up, no secondary degenerative changes in the associated joints of the hind part of the foot were identified on roentgenograms. The surgical technique appears to be appropriate and effective in the treatment of arthritis of the talocalcaneal joint in adults.
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905.