Hoke triple arthrodesis.

One hundred and nine cases of the Hoke triple arthrodesis which were done between 1945 and 1974 are reviewed. The results of the procedure are similar to other series insofar as correction of the deformity and the non-union rate are concerned. There was, however, an over-all incidence of aseptic necrosis of the talus of 6.5 per cent. A change in technique, in which the origin of the artery to the tarsal canal was left intact, has eliminated this complication. Excessive stress on the ankle joint as a result of the triple arthrodesis, although theoretically a problem, was not significant during follow-up of these patients. In the fourteen patients with myelomeningocele, there was acceleration of degeneration of the ankle joint, but Charcot joints did not develop.