Trephine Procedure for Revision Tarsometatarsal Arthrodesis Nonunion.

Nonunion of the tarsometatarsal arthrodesis site is a challenging revision surgery. Trephine technique provides an excellent option for revision tarsometatarsal joint arthrodesis. The authors have found the trephine approach to be the procedure of choice in correction of a nonunion. When the trephine approach is indicated, it offers many advantages including minimal soft tissue dissection, quicker joint preparation, and the minimal shortening of the arthrodesis site. This article describes in detail the autologous graft trephine technique for revision surgery of a tarsometatarsal nonunion. Examples of fixation options are also discussed.