The Advantages of a Dual Incisional Approach for Talonavicular Joint Preparation: A Cadaveric Comparison Study

This cadaveric study assessed common areas that were missed during talonavicular (TN) joint preparation. The purpose was to demonstrate to foot and ankle surgeons that an accessory incision can help prepare the lateral aspect of the joint to optimize the chances of a successful arthrodesis. We not only assessed the quadrants that were least likely prepped, but also the difference in surface area prepped between one and two incision approaches. Twenty cadavers in total were prepared by two fellowship-trained foot and ankle surgeons. The percentage of the unprepared cartilage in the talonavicular joints were calculated. It was found that both the dorsolateral and plantar lateral quadrants were more likely to have unprepared surfaces, with plantar lateral being the least prepped. The additional incision led to a decrease in the percentage of total unprepared surface. The results of the present study suggest that there is an advantage to prepping the talonavicular joint with both a medial and lateral incision to ensure all cartilage is denuded so a successful arthrodesis can be obtained.