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The Medial Double Arthrodesis

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

Abstract

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.

Keywords

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

Abbreviations

AAFD

Adult-acquired flatfoot deformity

AP

Anterior posterior

CT

Computed tomography

DBM

Demineralized bone matrix

FDL

Flexor digitorum longus

FHL

Flexor hallucis longus

NWB

Non-weight-bearing

PTT

Posterior tibial tendon

PTTD

Posterior tibial tendon dysfunction

STJ

Subtalar joint

TNJ

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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