A Long-Term Study of the Effect of Subtalar Arthrodesis on the Ankle and Hindfoot Joints

Yang, Chonglin; Xu, Xiangyang; Zhu, Yun; Liu, Jinhao; Wei, Baofu

doi:10.7547/14-002

Cited by 12 publications

(16 citation statements)

References 16 publications

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“…All of the above data were measured using our hospital's picture archiving and communication system UniWebViewer 6.1 (EBM Technologies, Inc., Taipei, Taiwan, PR China) software (4). If the calcaneovertical angle of Buck's view was greater than 7 , the foot was included in the valgus cases (7).…”

Section: Discussionmentioning

confidence: 99%

“…To reduce error from the measuring order, each series of 50 radiographs was randomly sorted before being measured. In the literature, the weight-bearing axis of the tibia is routinely determined by the mid-diaphyseal axis (1–6). We defined the mid-diaphyseal axis of the tibia by bisecting the tibia into two mid-diaphyseal points 50 mm apart and extending the line distally (6).…”

Section: Methodsmentioning

confidence: 99%

“…(5) was chosen to compare the angle of the mid-diaphyseal line of the tibia to the mid-diaphyseal line of the calcaneus (the calcaneotibial angle). The angle of calcaneal tilt (the calcaneovertical angle) was also measured (4). Meanwhile, the horizontal distance between the bottom of the calcaneus and the mid-tibial axis proposed by Saltzman and el-Khoury (3) that showed high reliability was obtained separately (Figs.…”

Section: Methodsmentioning

confidence: 99%

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Optimization of hindfoot alignment radiography

Yang

et al. 2016

Acta Radiol

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Background Cobey and Buck described methods to evaluate hindfoot alignment, but it is still unclear which method is better and easier to perform in clinical practice. Purpose To evaluate the optimal method for radiography of hindfoot alignment. Material and Methods We randomly selected 50 patients visiting the foot and ankle surgery outpatient department who underwent hindfoot alignment radiography between 1 July and 31 August 2015. Radiographs were taken using both Cobey's and Buck's methods. The patients were divided into three groups by calcaneal inclination angle. We assessed the calcaneotibial angle, calcaneovertical angle, and the distance from the bottom of the calcaneus to the mid-tibial axis. A comparative analysis was performed separately using the t-test. Results One hundred pairs of data for Cobey's and Buck's methods were obtained. The angles were analyzed separately in valgus, normal, and varus situations. The results showed no significant difference between Cobey's method and Buck's method regardless of any situation ( P > 0.05). Regarding the distance between the bottom of the calcaneus and the mid-tibial axis, the average result of Buck's method was about 1 mm larger than that of Cobey's method in the valgus and normal cases ( P < 0.05), except for varus cases ( P > 0.05). Conclusion Cobey's and Buck's techniques are the classic and popular hindfoot alignment assessment methods. The use of Buck's technique resulted in a better image with a less technical procedure and less time requirement. It is worthy of being popularized and used routinely for hindfoot radiography.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Optimization of hindfoot alignment radiography

Yang

et al. 2016

Acta Radiol

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“…Selective nerve dissection was performed in patients with disorders of nociception and proprioception in the tarsal sinus region (10). For STS patients combined with peroneal spasm, subtalar joint fusion was performed (19). All patients were treated according to the designed protocol (Figure 1).…”

Section: Propose Treatment Protocol For Stsmentioning

confidence: 99%

Staged surgical management of sinus tarsi syndrome: our experience of 273 cases

Yang¹,

Huang²,

Cao³

et al. 2021

Ann Palliat Med

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Background: The sinus tarsi syndrome (STS) is a common foot and ankle disease with controversial pathogenesis and treatment procedures. This long-term study aimed to analyze the effect of a staged surgical strategy for STS. Methods: Clinical data were retrospectively analyzed in 273 STS patients [129 men and 144 women; mean age: 36 years (10-60 years)] treated between 2006 and 2016. The 89 patients underwent different surgeries, including sinus tarsal debridement, subtalar joint stabilization, sinus tarsal denervation, tarsal coalition resection, or subtalar arthrodesis. The patients' American Orthopedic Foot & Ankle Society (AOFAS) anklehindfoot scores, visual analogue scale (VAS) scores for pain during daily activities, and 36-item short-form health survey (SF-36) scores at the first visit and latest follow-up were assessed by paired T-test. Results: The 89 patients who failed conservative treatments first underwent tarsal sinus soft tissue debridement, with 52 patients remaining in remission after 2 years. The other 37 patients with relapse underwent further surgeries. Five of the 19 patients with subtalar instability were cured following ligament reconstruction surgery. Two of the four patients with severe neurological signs recovered after nerve release surgery. Five of the 10 patients with tarsal coalition were cured by resection of the talocalcaneal bridge. A total of 21 patients failed their second operations due to peroneal spasm, and were eventually successfully treated by subtalar arthrodesis. In addition, subtalar arthrodesis was directly performed in the remaining four patients with peroneal spastic flatfoot. After the final operations, all patients achieved satisfactory results. The AOFAS ankle-hindfoot scores increased from 34.83±12.21 preoperatively to 85.52±7.07 postoperatively (t=−24.62, P<0.01), the VAS scores decreased from 8.14±1.52 to 2.14±1.00 (t=24.65, P<0.01), and the SF-36 scores increased from 36.58±11.36 to 86.22±9.17 (t=−28.13, P<0.01).Conclusions: In this study, we observed that 67% (184/273) of patients with STS need a staged surgical management. According to the etiology, symptoms, and severity, soft tissue surgery is the first choice.However, simple soft tissue surgeries may fail to achieve long-term results. Once the symptoms recur and become difficult to cure, the staged surgical strategy for STS we proposed can be the best choice to achieve long-term results.

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“…Causes of deformity include failure of the posterior tibial tendon which can aggravate deformity in valgus and lateral impact, causing pain in the tarsal region. Any trauma to the subtalar joint and posterior facet can lead to posttraumatic subtalar arthritis, and certain fractures of the calcaneus with severe comminution can benefit from this procedure (7)(8)(9) .…”

Section: Introductionmentioning

confidence: 99%

Arthroscopic subtalar arthrodesis – results and complications

et al. 2020

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Objective: The objective of this study is to evaluate the results and complications of the subtalar arthrodesis technique conducted via arthroscopy. Methods: Searches were run on PubMed/Medline and Google Scholar for publications dated from 2007 to 2020. Original articles were included that reported the results of at least one comparative postoperative scale. Methodological quality was assessed using the PRISMA tool. Union rate, complications, and the American Orthopedic Foot and Ankle Society (AOFAS) score were prioritized. Results: A total of 124 references were identified and, after application of the inclusion and exclusion criteria and the PRISMA tool, 9 articles were eligible. A total of 180 patients were analyzed, with mean postoperative follow-up of 18 months (± 6) and with before and after AOFAS scores varying from 44 to 79 with p<0.001, demonstrating statistical relevance with significant improvement of AOFAS scores during the postoperative period. Deformity correction, improvement of pain, and rates of union were good and there was clinical improvement according to postoperative AOFAS scores, with few complications. However, the heterogeneous nature of studies, withvariations in techniques and samples, prevents generalization of the findings. Conclusion: The results of arthroscopic surgery for subtalar arthrodesis are good and rates of complications are low, but there are stillfew studies with high evidence levels that demonstrate the efficacy of the technique, although preliminary results are encouraging. Level of Evidence I; Therapeutic Studies; Systematic Review.

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A Long-Term Study of the Effect of Subtalar Arthrodesis on the Ankle and Hindfoot Joints

Abstract: Subtalar arthrodesis is effective treatment for subtalar joint disease but could induce joint degeneration and ankle joint motion limitation related to talar declination and hindfoot height.

Cited by 12 publications

References 16 publications

Optimization of hindfoot alignment radiography

Optimization of hindfoot alignment radiography

Staged surgical management of sinus tarsi syndrome: our experience of 273 cases

Arthroscopic subtalar arthrodesis – results and complications

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