Spare the Talonavicular Joint! The Role of Isolated Subtalar Joint Fusion in the Treatment of Progressive Collapsing Foot Deformity

Abstract

Surgical management of progressive collapsing foot deformity continues to evolve. Previous studies have demonstrated that fusion of the talonavicular joint results in limited hindfoot motion and, therefore, may accelerate adjacent-joint arthrosis. Recent literature has supported using alternative arthrodesis constructs that spare the talonavicular joint, such as naviculocuneiform or isolated subtalar fusions, which may maintain some hindfoot motion through the talonavicular joint yet adequately address a patient's deformity. Concomitant reconstructive procedures may be used in addition to subtalar fusion to address severe deformities. Isolated subtalar fusions may be considered in cases of sinus tarsi or subfibular impingement deformities.

Keywords: Adult-acquired flatfoot deformity; Progressive collapsing foot deformity; Subfibular impingement; Subtalar arthrodesis; Subtalar impingement; Talonavicular arthrodesis; Weight-bearing CT scans.