Subtalar distraction arthrodesis for post-traumatic arthritis

ABSTRACT

Surgical fusion of the subtalar joint is the salvage procedure available for post-traumatic arthritis in adults. Combined distraction of the talo-calcaneal joint with iliac crest bone grafting and fixation with a screw was used to achieve a fusion of the talo-calcaneal joint in 32 adults [36 arthrodesis], 26 were males and 6 females. Their age ranged from 19 to 55 years [average 37 years]. The mean follow-up was twenty two months [range 12 - 30 months]. Based on the modified scoring system for pain and function of the hind foot, the results were good in 29 feet [80.6%], fair in 5 feet [13.9%] and poor in 2feet [5.5%], and overall 29 patients [30 feet] were satisfied with the operation. The indication of the operation is post-traumatic subtalar arthritis with pain. We concluded that subtalar distraction with iliac bone block and arthrodesis and fixation with internal compression screw was a satisfactory method for treating intra-articular calcaneal fractures with sub talar arthritis. It restores the anatomy between the hind foot and midfoot, restores the heal heigh and increases the Achilles tendon fulcrum. We advice to do it late three to six months after the injury to avoid the high complications of early fusion