Isolated talonavicular arthrodesis in patients with rheumatoid arthritis of the foot and tibialis posterior tendon dysfunction
نویسندگان
چکیده
BACKGROUND The foot is often affected in patients with rheumatoid arthritis. Subtalar joints are involved more frequently than ankle joints. Deformities of subtalar joints often lead to painful flatfoot and valgus deformity of the heel. Major contributors to the early development of foot deformities include talonavicular joint destruction and tibialis posterior tendon dysfunction, mainly due to its rupture. METHODS Between 2002 and 2005 we performed isolated talonavicular arthrodesis in 26 patients; twenty women and six men. Tibialis posterior tendon dysfunction was diagnosed preoperatively by physical examination and by MRI. Talonavicular fusion was achieved via screws in eight patients, memory staples in twelve patients and a combination of screws and memory staples in six cases. The average duration of immobilization after the surgery was four weeks, followed by rehabilitation. Full weight bearing was allowed two to three months after surgery. RESULTS The mean age of the group at the time of the surgery was 43.6 years. MRI examination revealed a torn tendon in nine cases with no significant destruction of the talonavicular joint seen on X-rays. Mean of postoperative followup was 4.5 years (3 to 7 years). The mean of AOFAS Hindfoot score improved from 48.2 preoperatively to 88.6 points at the last postoperative followup. Eighteen patients had excellent results (none, mild occasional pain), six patients had moderate pain of the foot and two patients had severe pain in evaluation with the score. Complications included superficial wound infections in two patients and a nonunion developed in one case. CONCLUSIONS Early isolated talonavicular arthrodesis provides excellent pain relief and prevents further progression of the foot deformities in patients with rheumatoid arthritis and tibialis posterior tendon dysfunction.
منابع مشابه
Isolated Talonavicular Arthrodesis in Patients with Dysfunction of Tibialis Posterior and Rheumatoid Arthritis
متن کامل
Anterior Ankle Arthrodesis with Molded Plate: Technique and Outcomes
Background: There is still controversy regarding the best technique for ankle arthrodesis to acheive stable rigid fixation along with reconstructing a functional plantigrade foot. Moreover, existing techniques have complictions related to stability, soft tissue covering, fusion rate, and exposure. Methods: With the anterior approach exactly on the tibialis anterior sheath, the joint was expose...
متن کاملFlatfoot in Müller-Weiss syndrome: a case series
INTRODUCTION Spontaneous osteonecrosis of the navicular bone in adults is a rare entity, known as Müller-Weiss syndrome. We report here on our experience with six patients with Müller-Weiss syndrome accompanied by flatfoot deformity, but on a literature search found no reports on this phenomenon. Because the natural history and treatment are controversial, an understanding of how to manage this...
متن کاملNew method for fixation point of tibialis posterior tendon transfer
Background: The transfer of the tibialis posterior tendon to the dorsum of foot can restore the function of the paralyzed dorsiflexor muscles of the foot and ankle. In order to reduce the wound complication in the insertion site of tendon to bone by a plantar knop we used a new method of fixation by an absorbable screw inserted dorsally. Methods: we performed this operation on 15 patients in...
متن کاملPatients and Methods
The painful pes planovalgus foot type includes a range of deformities. Causes for the symptomatic pes valgus deformity include posterior tibial tendon dysfunction, subluxation of the talus, triceps surae or isolated gastrocnemius equinus, traumatic tendon rupture, ligament laxity, and various neuromuscular imbalances. Detailed discussion of the anatomy and physiology of the symptomatic pes plan...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 11 شماره
صفحات -
تاریخ انتشار 2010