A Look at Triple Arthrodesis Joint Fusion without Rigid Internal Fixation

Abstract

Triple arthrodesis is an invasive procedure that involves denuding and fusion of three foot joints; Talocalcaneal (T-C), Talonavicular (T-N) and Calcaneocuboid (C-C). Traditionally, with external fixation triple arthrodesis has been per-formed without corresponding internal fixation. The purpose of this study is to take a scientific look at the compressive forces acting on the joint surfaces using the arch wire technique without the use of rigid internal fixation. Five fresh cadaveric lower-limb specimens were prepared for the triple arthodesis by anatomic dissection. External fixators were applied to the limbs and pressure sensors from the Tekscan 6900C were placed in the three foot joints where tension was applied. After several trials with different variables it was seen that the arched wire technique on the footplate alone does not allow constant compression at the three joints. However weightbearing increased compression across all three joints regardless of the arch wire compression. This study proves that weightbearing alone provides more compression at all 3 joints in a triple arthrodesis.