TRIPLE ARTHRODESIS – IS BONE GRAFTING NECESSARY?

Introduction and Aims: Non-union following triple arthrodesis has been significant, up to 23%. Iliac crest bone grafting and internal fixation has reduced this to 0–4%. Harvesting bone graft incurs significant donor site morbidity and may be unnecessary. We present the results of 100 triple arthrodeses performed with local graft, avoiding donor site complications.Method: Between January 1993 and July 2002 the senior author performed 112 triple arthrodeses. We performed a retrospective chart review, evaluating the incidence of union and the post-operative complications, with a minimum follow-up of six months. For this study, we excluded all (seven) revision fusions, and all (five) fusions using iliac crest or other donor site graft (e.g. calcaneus or tibia). One hundred fusions were performed using a standard technique with internal fixation and without supplementary bone graft. All patients were reviewed until fusion had occurred or non-union declared.Results: Ninety-six patients had one hundred triple ar...