Objective: The purpose of this study is to present the surgical outcomes of twelve patients undergoing arthroscopic subtalar arthrodesis using two lateral portals (anterior and medial) in the sinus tarsi. Methods: A retrospective study was conducted with twelve patients (7 men and 5 women) with a mean age of 55.1 (36-74) years who underwent arthroscopic subtalar arthrodesis through the sinus tarsi between May 2015 and December 2016. The post-surgical follow-up was 12 months. Consolidation time and postoperative complications were evaluated, and a validated functional questionnaire from the American OrthopedicFoot and Ankle Society (AOFAS) and the visual analog scale (VAS) for pain were applied both before and after surgery. Results: The mean bone fusion time was 11.5 weeks. Bone consolidation was observed in all analyzed patients. Four patients developed late complications, three of which were related to screw positioning in the calcaneus, while one was related to residual hindfoot varus deformity. Screw-related complications are common with all subtalar arthrodesis techniques, and such complications are considered less relevant when evaluating the effectiveness of the presented technique. The mean preoperative AOFAS score was 42.3 (27-66) points, while the mean postoperative score was 83 (73-94) points. The mean preoperative VAS score for pain was 8.1 (5-10) points, and the mean postoperative score was 2.1 (0-5) points. The above data are similar to those reported in other published studies and reflect high bone consolidation rates. Conclusion: Arthroscopic subtalar arthrodesis through two lateral portals in the sinus tarsi is a safe and effective technique for the treatment of primary and secondary disorders of the subtalar joint. Correct positioning of screws and hindfoot alignment must be carefully ensured to avoid complications related to the synthesis material and hindfoot varus deformity. Level of Evidence IV; Therapeutic Studies; Case Series.

Objective: To describe the technique and results of arthroscopic arthrodesis through lateral portals in clinical cases of medial subtalar coalition. The posterior arthroscopic technique is considered the most difficult method for coalition resection. Methods: Five patients were operated on from April 2015 to July 2018, a study period of approximately 2 years and 3 months. The patients’ age ranged from 37 years and 6 months to 58 years and 1 month, with a mean age of 44 years and 5 months. All patients were operated on through 2 lateral portals using an eyepiece and knee and shoulder arthroscopic surgery instruments, and fixation was performed using 6.5- and 7.0-mm screws. The use of osteotomes was combined with curettes for coalition osteotomy and fusion release. An accessory lateral posterior portal was also used in one patient. Results: The patients were evaluated at 1, 2, 4 and 6 weeks and subsequently at 3 months, when computed tomography was performed to confirm the fusion. The final evaluations were performed at 6 months and 1 year. At the initial evaluation, the mean American Orthopedic Foot and Ankle Society Score (AOFAS) score was 56.7 points preoperatively; it increased to 87.4 after the blocked inversion/eversion was addressed through arthrodesis. Conclusion: This coalition osteotomy and curettage technique involving the release of the blocked subtalar motion to achieve fusion of the posterior, anterior and medial portions of the subtalar joint was found to be feasible through arthroscopic lateral portals. We recommend this procedure as long as no valgus deformity or significant abduction is present.

Ankle fractures are common and represent approximately a quarter of all lower limb fractures. The general concepts for osteosynthesis techniques for deviated and unstable fractures have undergone little change since the 1960s. The presence of comorbidities and poor soft tissue conditions, especially in elderly patients, is associated with a higher rate of postoperative complications. Intramedullary implants have the advantage of using smaller incisions, which minimizes skin damage allowing for early loading. The present technical note describes the use of the fibular intramedullary nail with a minimally invasive approach to deviated and unstable ankle fractures.

Objective: The purpose of this study is to present the surgical outcomes of 12 patients who underwent arthroscopic subtalar arthrodesis using 2 lateral portals (anterior and medial) in the sinus tarsi. Methods: A retrospective study was conducted with 12 patients (7 men and 5 women) with a mean age of 55.1(36-74) years who underwent arthroscopic subtalar arthrodesis through the sinus tarsi from May 2015 to December 2016. The postsurgical follow-up period was 12 months. Union time and postoperative complications were evaluated, and a validated functional questionnaire from the American Orthopedic Foot and Ankle Society (AOFAS) and the pain visual analog scale (VAS) were applied before and after surgery. Results: The mean time to bone fusion was 11.5 weeks. Bone union occurred in all subjects. Four patients developed late complications, 3 of which were related to screw positioning in the calcaneus and one of which was related to residual hindfoot varus deformity. Screw-related complications are common among subtalar arthrodesis techniques, and such complications are considered minor when the effectiveness of the technique is considered. The mean preoperative AOFAS score was 42.3 (27-66) points, whereas the mean postoperative score was 83 (73-94) points. The mean preoperative pain VAS score was 8.1 (5-10) points, and the mean postoperative pain VAS score was 2.1 (0-5) points. The above data are similar to those reported in the main published studies and reflect high bone union rates. Conclusion: Arthroscopic subtalar arthrodesis through 2 lateral portals in the sinus tarsi is a safe and effective technique for the treatment of primary and secondary disorders of the subtalar joint. Surgeons must carefully position the screws and align the hindfoot to avoid complications related to orthopedic hardware and hindfoot varus deformity.

Introduction: Hallux rigidus (HR) is a frequent pathological condition of the foot, responsible for marked functional impairment. Metatarsal-phalangeal arthrodesis is an excellent treatment alternative for advanced stages of the disease, usually performed as an open surgery. Forefoot arthroscopy had its greatest development in the last decade, with a progressive expansion of indications, yielding encouraging results. Objective: To present the clinical and radiographic results of patients undergoing arthroscopic metatarsal-phalangeal arthrodesis of the hallux, depicting the technique and reporting complications. Methods: This study involves a series of cases, we operated 9 patients (10 feet), all with advanced HR (grades 3 and 4 - Coughlin-Shurnas). The patients underwent an arthroscopic procedure through two dorsal portals, small joints instruments. We assessed the results using the AOFAS functional score and the visual analogue pain scale. The radiographic parameters we used to analyze were the metatarsal-phalangeal angulation in the anteroposterior (pre- and postoperative) and lateral (post-operative) views, and we measured the radius shortening. Conclusion: Arthroscopic metatarsal-phalangeal arthrodesis is an excellent treatment option in advanced stages of hallux rigidus, with minimal disruption and providing excellent results, in addition to a low incidence of complications. Level of Evidence IV; Therapeutic Studies; Case Series