Oruç KELEŞ
Journal of Surgery and Medicine - 2026;10(5):158-160
Isolated talonavicular (TN) joint arthritis is uncommon because the TN joint is typically affected together with other midfoot articulations. As a multiaxial component of the medial column, the TN joint plays a key role in stability during gait. TN arthrodesis is indicated in conditions such as post-traumatic arthritis, rheumatoid arthritis, posterior tibial tendon insufficiency, and structural foot deformities, with generally favorable clinical outcomes. We report a 52-year-old woman with rheumatoid arthritis who presented with severe dorsal right foot pain, most pronounced during the mid-stance phase of gait. Clinical and radiographic evaluation demonstrated isolated TN arthritis without subtalar or talocalcaneal involvement. Arthrodesis was performed using a distraction technique with a monolateral external fixator to maintain a neutral midfoot position and help prevent collapse of the medial arch. The patient experienced progressive pain relief and functional improvement during follow-up, with substantial reduction in pain and restoration of independent ambulation. This case suggests that external fixation with distraction may represent a useful alternative technique for isolated TN arthrodesis and warrants evaluation in larger series.
