BACKGROUND: The aim of this study was to evaluate the results of a series of subtalar arthrodeses done by a single surgeon using a standard technique. METHODS: A retrospective review of 95 primary isolated subtalar arthrodeses in 92 patients was done. Original diagnoses included post-traumatic subtalar arthrosis, primary osteoarthrosis, talocalcaneal coalition, and inflammatory joint disease. In all arthrodeses, a single 7.0-mm partially-threaded cancellous screw was used for fixation, and autogenous bone graft was used. Structural iliac crest autograft was required to restore heel height in three feet with post-traumatic arthrosis. In these three, autograft was harvested from the iliac crest with the remainder receiving morcellized autograft either from the tibia, fibula, or calcaneus. RESULTS: No patients were lost to followup. Ninety-five percent (87) of patients went on to bony union radiographically. Using the Angus and Cowell rating system, 93% (88 feet) of patients had a good or fair outcome. There were seven poor results: four arthrodeses failed to unite, two patients had persistent hindfoot pain in spite of radiographic union, and one developed post-traumatic ankle arthrosis. CONCLUSIONS: The results of isolated subtalar arthrodesis using a single screw for fixation are comparable to other fixation methods. Bone graft from local sites obviates the need for iliac crest autograft in most patients.
BACKGROUND: The aim of this study was to evaluate the results of a series of subtalar arthrodeses done by a single surgeon using a standard technique. METHODS: A retrospective review of 95 primary isolated subtalar arthrodeses in 92 patients was done. Original diagnoses included post-traumatic subtalar arthrosis, primary osteoarthrosis, talocalcaneal coalition, and inflammatory joint disease. In all arthrodeses, a single 7.0-mm partially-threaded cancellous screw was used for fixation, and autogenous bone graft was used. Structural iliac crest autograft was required to restore heel height in three feet with post-traumatic arthrosis. In these three, autograft was harvested from the iliac crest with the remainder receiving morcellized autograft either from the tibia, fibula, or calcaneus. RESULTS: No patients were lost to followup. Ninety-five percent (87) of patients went on to bony union radiographically. Using the Angus and Cowell rating system, 93% (88 feet) of patients had a good or fair outcome. There were seven poor results: four arthrodeses failed to unite, two patients had persistent hindfoot pain in spite of radiographic union, and one developed post-traumatic ankle arthrosis. CONCLUSIONS: The results of isolated subtalar arthrodesis using a single screw for fixation are comparable to other fixation methods. Bone graft from local sites obviates the need for iliac crest autograft in most patients.
Authors: Alexej Barg; Matthias D Wimmer; Martin Wiewiorski; Dieter C Wirtz; Geert I Pagenstert; Victor Valderrabano Journal: Dtsch Arztebl Int Date: 2015-03-13 Impact factor: 5.594
Authors: Ian D Hutchinson; Josh R Baxter; Susannah Gilbert; MaCalus V Hogan; Jeff Ling; Stuart M Saunders; Hongsheng Wang; John G Kennedy Journal: Clin Orthop Relat Res Date: 2015-12-21 Impact factor: 4.176
Authors: Tim Schepers; Brenda C T Kieboom; Gert H J M Bessems; Lucas M M Vogels; Esther M M van Lieshout; Peter Patka Journal: Strategies Trauma Limb Reconstr Date: 2010-03-23