A Comparative Retrospective Radiographic Analysis of the Outcomes of Double and Triple Arthrodesis in the Correction of Severe Flatfoot Deformity

Abstract

Category: Hindfoot; Midfoot/Forefoot Introduction/Purpose: Choosing between a double arthrodesis or a triple arthrodesis in treating severe flatfoot deformities is often a matter of surgeon preference with proponents of each, and this study compared the radiographic outcomes of the two procedures. Methods: A retrospective chart review was performed for patients who underwent either a double or triple arthrodesis during a period of one year. Twenty-one double and 9 triple arthrodesis with at least one year of follow up were included in this study. Radiographic measurements on pre and postoperative anteroposterior and lateral weightbearing images were collected to reflect the correction of the hind and midfoot deformities, in particular, the relative height of the medial and lateral columns. Results: Both procedures significantly improved the talus-1st metatarsal angle (AP), talar declination angle, and the Meary’s angle. The double arthrodesis more significantly improved the talo-navicular coverage angle, while the triple arthrodesis significantly was far more effective in correcting the talar declination angle, the calcaneal pitch angle, and the cuneiform/cuboid height ratio. (Tables 1,2) Conclusion: Both double and triple arthrodesis have the ability to correct severe flatfoot deformities with improved radiographic outcomes. The triple arthrodesis has more power to improve the arch height as noted on the significant differences between the two groups in the calcaneal pitch angle and the medial cuneiform/cuboid height ratio.