Subtalar arthrodesis with correction of deformity after fractures of the os calcis

Abstract

We have reviewed the long-term results of 22 patients (23 fusions) with fractures of the os calcis, who had subtalar arthrodesis with correction of the deformity between 1975 and 1991. The mean follow-up was nine years (5 to 20). All patients were evaluated according to a modified foot score. A radiological assessment was used in which linear and angular variables were measured including the fibulocalcaneal abutment, the height of the heel and fat pad, the angle of the arch and the lateral talocalcaneal and the lateral talar declination angles. The technique used restores the normal relationship between the hindfoot and midfoot and corrects the height of the heel. This leads to better biomechanical balance of the neighbouring joints and gives a favourable clinical outcome. The modified foot score showed a good or excellent result in 51% of the feet. Residual complaints were mostly due to problems with the soft tissues. Subjectively, an excellent or good score was achieved in 78% of the cases. After statistical analysis, except for the height of the heel and the degenerative changes in the calcaneocuboid joint, no significant difference was found in the measured variables between the operated and the contralateral side.

Computer based systems in foot and ankle surgery at the beginning of the 21st century

“…The biomechanical consequences of these deformities frequently lead to clinical symptoms like pain and gait disturbances [2,12,33,39,42,53,58,65,68,71]. The correction of the deformities is challenging [5,67,71].…”

“…For any kind of reduction or correction at the foot and ankle an immediate biomechanical assessment of the reduction result would be desirable [2,12,33,39,42,53,58,65,68,71]. This is especially true for a CAS guided reduction or correction, which is supposed to be more accurate than a conventional reduction [46].…”

“…The significance of the introduced CAS methods is high in those cases, because the improved accuracy may lead to an improved clinical outcome like complex corrections in the hind-and midfoot deformities [2,7,12,33,39,42,53,58,65,68,71]. CAS is too complex and time consuming for all those cases that are accurately and easily performed by the experienced surgeon.…”

Die subtalare Korrekturarthrodese nach fehlerhaft verheilter Fersenbeinfraktur

“…Nach fehlerhaft verheilter intraartikulärer Fersenbeinfraktur resultieren in der Regel eine Abflachung des Tubergelenkwinkels, eine Abflachung des Fuß-längsgewölbes, eine Valgus-Rückfußfehlstellung sowie eine Verbreiterung, Höhenminderung und Verkürzung des Rückfußes, eine Inkongruenz im Subtalargelenk sowie ein mögliches Impingement der Peronealsehnen [3,6,10]. Für den Patienten ergeben sich in der Mehrzahl der Fälle chronische Schmerzen und eine funktionelle Einschränkung der Gehfähig-keit.…”

Belastungsstabile Subtalararthrodese mit I.CO.S�-Schrauben

“…Its primary goal is pain-free weight bearing and stability of the hindfoot. After removal of the articular cartilage from the three facets, fixation can be achieved with one [1] or two screws [3] introduced from dorsal or plantar or with staples [4,7]. Addition of cancellous or cortical bone grafts is used, and, recently, bone substitutes are employed.…”