[Osteosynthesis of talonavicular fusion with a claw plate and compression screw].

OBJECTIVE

A new method of osteosynthetic stabilization of talonavicular fusion is presented.

INDICATIONS: Idiopathic and posttraumatic talonavicular arthritis, talonavicular destruction in rheumatoid arthritis, adult acquired flatfoot deformity, cavovarus deformity, talonavicular degenerative disease in tarsal coalition.

CONTRAINDICATION: Major hindfoot deformity or instability, severe osteopenic conditions of tarsal bones.

SURGICAL TECHNIQUE: Talonavicular fusion is stabilized with a medioplantar 6.5-mm lag screw in combination with a dorsolateral 3.5-mm claw plate (Charlotte Claw compression plate; Fa. Wright Medical Technology, Memphis, USA) by a dorsal surgical access.

POSTOPERATIVE MANAGEMENT: Nonweight-bearing in a cast or walker for 6 weeks; after radiologic control increasing weight-bearing is allowed.

RESULTS

The technique was used in 44 patients, among them 31 cases of isolated talonavicular fusion. Complete bony healing was observed in 42 cases after medium follow-up time of 13.3 months. All 19 cases of isolated talonavicular fusion without posterior tibial tendon dysfunction healed uneventfully; two cases of non-union were observed in 12 patients with posterior tibial tendon dysfunction.