Original Research
Average Depth of Tarsometatarsal Joint for Trephine Arthrodesis

https://doi.org/10.1053/j.jfas.2011.10.028Get rights and content

Abstract

The trephine arthrodesis technique has been shown to be an effective method for various foot and ankle fusion procedures, with acceptable rates of fusion reported. The tarsometatarsal joints are an excellent example for this procedure because of the joint shape and soft tissue stability. The success of this procedure depends on many factors, but a large consideration is adequate joint resection. A cadaveric study to examine the joint depth of the Lisfranc complex was undertaken, allowing for improved understanding of the resection needed to maintain a stable plantar cortex while removing all apposing joint surfaces. A statistical analysis was then performed to determine the significance of the joint depth to available demographic data. A total of 51 limbs were evaluated for the depth of the first, second, and third metatarsal-cuneiform joints. The average joint depth for the first through third metatarsal-cuneiform joints was 32.3, 26.9, and 23.6 mm, respectively. The plantar cortex depth was less than 2 mm for the first through third metatarsal-cuneiform joints. The correlation between the length of the foot and the joint depth was statistically significant. Subgroups stratified by shoe size were analyzed for differences in joint size and were also statistically significant. A better understanding of the tarsometatarsal joint anatomy would benefit the trephine technique for Lisfranc arthrodesis.

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Materials and Methods

A total of 51 fresh-frozen, cadaveric limbs were used in the present investigation after institution review board approval. The cadaveric specimens were procured from Biogift Anatomical Inc. (Portland, OR). The available data were obtained from the individual specimens, including age, gender, laterality, and shoe size. The data were collected from August 2010 through October 2010. The foot length was first measured in millimeters, and a Brannock device was then used to record the U.S. shoe size.

Results

The mean foot length for the 51 limbs was 24.5 cm (U.S. men’s size 6 and women’s size 7.5). The mean joint depth for the first through third MC joint was 32.3, 26.9, and 23.6 mm, respectively (Table 1). The mean age of these subjects was 74.5 years. Of the 51 limbs, 28 were right limbs and 23 were left limbs. The frequency of each foot length and joint depth were also recorded (Table 2). Some limbs did not include all demographic data, including age and gender; therefore, statistical analysis

Discussion

The data collected from the present trial showed the average joint depth for the first through third MC joints and average plantar cortex depth (Table 7). These results should assist surgeons when performing Lisfranc trephine fusion procedures.

Additionally, statistically significant results were found to support the claim that an increased foot length leads to an increase in joint depth. This must be accounted for when performing these procedures. We have attempted to simplify this process by

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    Financial Disclosure: None reported.

    Conflict of Interest: None reported.

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