Abstract
This paper presents the first report of a prospective study to assess the outcome of using coregistration localisation and selective arthrodesis in chronic midfoot degenerative arthritis.
In a previous report from Cambridge (J Bone Jt Surg [Br]1998; 80B:777), a new coregistration imaging technique in the foot was described, using superimposed X-rays and technetium scintigram and showing significantly higher anatomical localisation of active joint disease than either alone.
Nineteen consecutive patients over a three-year period (1996–9) with severe midfoot joint pain and disability of over six months’ duration underwent coregistration imaging followed by selective arthrodesis. The procedures involved 17 patients with one-level single or multiple fusions of the metatarsocuneiform, metatarsocuboid or naviculocuneiform joints, and two patients with two-level multiple fusions.
Pain and functional assessments were recorded pre-operatively and at one and at two to four years postoperatively using the American Orthopaedic Foot and Ankle Society Midfoot Scoring System. Bone union was determined clinically and with X-rays.
Results showed fusions in all 19 patients between 10 and 15 weeks. Three K-wires and one screw required removal for later prominence and there was one delayed wound healing. Pian and functional scores showed significant differences between the pre- and post-operative and one year measurements, and less between the one year and two to four year scores.
This preliminary study concludes that there is a high correlation between the coregistration localisation of the midfoot degenerative arthropathies and the successful results of selective fusion of these joints for the one to four year follow-up period.
The abstracts were prepared by Mr J. L. Barrie. Correspondence should be addressed to Mr J. L. Barrie, BOFSS Editor, Department of Orthopaedic Surgery, Blackburn Royal Infirmary, Blackburn, Lancashire BB2 3LR.
