Hindfoot fusion is capable of correcting hindfoot
deformities. Typically, this has been done through triple
arthrodesis. Recently, there has been some discussion of a double
arthrodesis, sparing the calcaneocuboid joint. We compared the radiographic corrective ability of these 2 fusion techniques. A retrospective radiographic review was performed of 20 consecutive triple
arthrodeses (triple) and 20 consecutive talonavicular and subtalar
arthrodesis with calcaneocuboid preservation (double). Additional midfoot
arthrodesis or
osteotomy was performed as needed in each group. The preoperative measurements were compared to those from standing weightbearing films after fusion postoperatively. The angular measurements included the anteroposterior and lateral talar–first metatarsal line (Meary's and Simmons) and the anteroposterior and lateral talocalcaneal angle. Both groups demonstrated a statistically significant reduction in
deformity and a return to more normal radiographic findings after
arthrodesis (p < .05). The 2 groups did not differ statistically in preoperative
deformity or correction obtained (p > .05). Traditionally, triple
arthrodesis has been advocated for significant hindfoot
deformity that is irreducible. Recent studies have questioned the need for inclusion of the calcaneocuboid joint in the
arthrodesis, in particular, in a pronated, valgus-type foot. In addition, others have advocated a strictly medial approach to hindfoot fusion, necessarily avoiding the calcaneocuboid joint. Our findings agree with the assertion that hindfoot
deformity can be adequately and reliably corrected through hindfoot
arthrodesis whether or not the calcaneocuboid joint is included.