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Early Experience of Talonavicular Arthrodesis Using an Intraosseous Fix System: A Case Series

Zanolli, Diego H. MD*; Johnson, Julie MD; DiGiovanni, Christopher MD; Adams, Samuel B. MD*; Parekh, Selene G. MD, MBA*,‡

Techniques in Foot & Ankle Surgery: September 2013 - Volume 12 - Issue 3 - p 147–152
doi: 10.1097/BTF.0b013e31829f0f11

Talonavicular arthrodesis is generally recommended for treating isolated degenerative arthritis and deformities of this joint. In general, good results have been published in the literature; however, nonunion of the talonavicular joint still remains a factor, which can affect outcome. We report our first 4 cases of isolated talonavicular arthrodesis using a novel intraosseous device designed to increase the stability of fixation generated across this joint. The system takes advantage of an intraosseous titanium post introduced into the navicular, through which a lag screw can thereafter be oriented across the talar neck and body. Surgical exposure can be minimized and compression can be achieved using leverage of the entire navicular rather than through a small medial portion of the tuber, obtaining a more stable and rigid construct that facilitates fusion and has been designed to permit early mobilization. The device provides the option of creating either a fixed angle Morse taper lock at the postlag interface or a polyaxial design capable of greater angular freedom. Pearls with respect to preoperative planning and technique and early results and complications are reviewed.

*Department of Orthopaedic Surgery, North Carolina Orthopaedic Clinic, Duke University Medical Center, Durham, NC

The Fuqua School of Business, Duke University, Durham, NC

Department of Orthopaedic Surgery, Brown University, Providence, RI

S.G.P. and C.D. have financial relationships with Extremity Medical, the manufacturer of the IO Fix intraosseous fixation device. The remaining authors declare no conflict of interest.

Address correspondence and reprint requests to Selene G. Parekh, MD, MBA, Department of Orthopaedic Surgery, North Carolina Orthopaedic Clinic, Duke University Medical Center, 3609 SW Durham Dr, Durham, NC 27709. E-mail:

© 2013 by Lippincott Williams & Wilkins