Abstract
Isolated talonavicular arthrodesis is a common procedure particularly for posttraumatic arthritis and rheumatoid arthritis. Two surgical approaches are commonly used: the medial approach and the dorsal approach. It is recognized that access to the lateral aspect of the talonavicular joint can be limited when using the medial approach and it is our experience that using the dorsal approach addresses this issue. We performed an anatomical study using cadaver specimens, to compare the amount of articular surface that can be accessed, and therefore prepared for arthodesis, by each surgical approach. Medial and dorsal approaches to the talonavicular joint were performed on each of 10 cadaveric specimens. Distraction of the joint was performed as standard for preparation of articular surfaces during talonavicular arthrodesis. The accessible area of articular surface was marked for each of the two approaches.
Disarticulation was performed and the marked surface area was quantified using a digital Microscribe allowing a three dimensional virtual model of the articular surfaces to be assessed.
This study will provide quantifiable measurements of the articular surface accessible by the medial and dorsal approaches to the talonavicular joint.
These data may provide support for the use of the dorsal approach for talonavicular arthrodesis.
