Early Experience of Talonavicular Arthrodesis Using an Intraosseous Fix System: A Case Series

Talonavicular arthrodesis is generally recommended for treating isolated degenerative arthritis and deformities of this joint. In general, good results have been published in the literature; however, nonunion of the talonavicular joint still remains a factor, which can affect outcome. We report our first 4 cases of isolated talonavicular arthrodesis using a novel intraosseous device designed to increase the stability of fixation generated across this joint. The system takes advantage of an intraosseous titanium post introduced into the navicular, through which a lag screw can thereafter be oriented across the talar neck and body. Surgical exposure can be minimized and compression can be achieved using leverage of the entire navicular rather than through a small medial portion of the tuber, obtaining a more stable and rigid construct that facilitates fusion and has been designed to permit early mobilization. The device provides the option of creating either a fixed angle Morse taper lock at the postlag interface or a polyaxial design capable of greater angular freedom. Pearls with respect to preoperative planning and technique and early results and complications are reviewed.