Subtalar arthrodesis with internal compression for post-traumatic arthritis

Abstract

We studied retrospectively the results in 24 patients (25 feet) who had been treated by subtalar arthrodesis with internal compression for post-traumatic arthritis from 1988 to 1992. Fifteen patients were men (16 feet) and nine (9 feet) were women. Their mean age was 43 years (22 to 68), and the average duration of follow-up was four years (2 to 6). A single compression screw was used in all feet and iliac-crest bone grafting in ten.Union was achieved in 24 of the 25 feet (96%). Based on a clinical scale the results were excellent in 10 feet, good in 7, fair in 6, and poor in 2 and on the Angus and Cowell score they were good in 19 feet, fair in 4, and poor in 2. The two poor results were due to nonunion in one patient and reflex sympathetic dystrophy in the other. One reoperation was performed for nonunion. Eighteen patients (18 feet) were satisfied with the results, four were satisfied with reservations, and three were dissatisfied. Progressive ankle and midfoot arthritis did not occur in the absence of pre-existing degenerative changes in these joints.We conclude that isolated subtalar arthrodesis with internal compression was effective treatment for posttraumatic subtalar arthritis. Iliac-crest bone grafting was not routinely required.

Foot function after subtalar distraction bone-block arthrodesis

“…1,2,4,9,13,21 Besides painful subtalar arthritis secondary to joint incongruity, displaced calcaneal fractures may result in substantial hindfoot malalignment. While in situ arthrodesis has been reported to be successful in cases of isolated subtalar arthritis, 2,6,7,[22][23][24][25] gross depression and/or axial deviation of the calcaneum requires correction of calcaneal height and width as well as restoration of malalignment of the axial hindfoot. 2,5,8,10,25 Subtalar distraction bone-block arthrodesis was first described by Carr et al 8 and has been reported in several retrospective series since.…”

“…This approach, puts the neurovascular structures at risk and may lead to anterior tibiotalar impingement at the head of the screw. 23 Since the eversion/inversion movement of the subtalar joint allows adaptation of the foot on uneven ground, the loss of shock absorption after subtalar fusion could have provoked pain beneath the screw heads in some of the patients although the heads were not prominent. Results of follow-up.…”

Subtalar arthrodesis stabilisation with screws in an angulated configuration is superior to the parallel disposition: a biomechanical study

“…Advantages of it are said to be an easier initial approach, availability of the denser talar bone and a reduced risk of damage to the neurovascular bundle [2,6,10].…”

“…Achieving a secure bony fusion is also crucially dependant on mechanical factors, particularly compression and stability between the articular surfaces [6,7]. Therefore, the primary surgical goal is to secure early stability of the arthrodesis in order to encourage bony fusion in the desired anatomical position [6][7][8][9].…”

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.…”