The Medial Double Arthrodesis

  • Bradly W. Bussewitz
  • Christopher W. Reb
  • David Larson


The medial double arthrodesis includes arthrodesis of the subtalar and talonavicular joints and is rapidly overtaking the traditional standard triple arthrodesis as the preferred surgical treatment of rigid late stage pes planovalgus deformity. Both procedures share similar indications; however, a growing body of evidence is showing improved outcomes following medial double fusion. The corrective strength of the medial double is powerful, yet the calcaneal cuboid joint is allowed to remain mobile. The surgical technique is reproducible. The joints to be fused are easily accessed and visualized. The postreduction medial side soft tissue redundancy allows for improved incision healing, especially when compared to laterally based, tension side, incisions. Surgeons are embracing the decreased operating room time, less extensive dissection, decreased hardware needs, and equivocal or improved outcomes of the medial double when compared to triple arthrodesis. What follows is a chapter dedicated to the medial double arthrodesis including a step-by-step surgical technique.


Posterior tibial tendon dysfunction Flatfoot Pes planovalgus Medial double arthrodesis Subtalar joint fusion Talonavicular fusion Rearfoot Triple arthrodesis Osteoarthritis 



Adult-acquired flatfoot deformity


Anterior posterior


Computed tomography


Demineralized bone matrix


Flexor digitorum longus


Flexor hallucis longus




Posterior tibial tendon


Posterior tibial tendon dysfunction


Subtalar joint


Talonavicular joint


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Bradly W. Bussewitz
    • 1
  • Christopher W. Reb
    • 2
  • David Larson
    • 3
  1. 1.Steindler Orthopedic ClinicIowa CityUSA
  2. 2.University of Florida, Department of Orthopedics, Division of Foot and Ankle SurgeryGainesvillesUSA
  3. 3.Steward Health Care, Department of PodiatryGlendaleUSA

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