Treatment of malunited calcaneus fracture with subtalar distraction bone block fusion / 中华外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To report and evaluate the results of subtalar distraction bone block fusion in the treatment of malunited calcaneus fracture.</p><p><b>METHODS</b>From September 2004 to January 2008, 32 cases of malunited calcaneus fracture were treated, among which 28 cases were classified type II and 4 cases type III by Stephens-Sander's classification. Preoperative X-ray and CT examination demonstrated a talocalcaneal angle of 18.1 degrees ± 2.3 degrees , and an AOFAS score of 36.3 ± 4.1. Subtalar distraction bone block fusion was performed in all cases in this series. Regular follow-up was done with talocalcaneal angle measurement and AOFAS scoring.</p><p><b>RESULTS</b>All the 32 patients had been followed-up of 34 months, ranging from 24 to 65 months, only to reveal a primary wound healing without infection in all but one, in which superficial skin necrosis occurred postoperatively and healed after dressing-changes. Bone healing at the fusion site was seen 3 months after operation in all cases. At the final follow-up, the talocalcaneal angle was 22.9° ± 1.9° and the AOFAS score 77.5 ± 4.1, both demonstrating a significant difference (P < 0.05), when compared with those before operation.</p><p><b>CONCLUSION</b>Subtalar distraction bone block fusion, together with the lateral wall decompression, can correct the main deformity and reduce major symptoms induced by the malunion of calcaneus fractures, being a convenient and practical option for the treatment of malunited calcaneus fracture.</p>