Journal of Musculoskeletal Trauma

Computed Tomography Image Analysis of the Fusion Site of Subtalar Arthrodesis for Traumatic Arthritis after a Displaced Intraarticular Calcaneal Fracture: Hong Gi Park, Jae Ang Sim, Han Soul Kim, Byung Hoon Lee; J Korean Fract Soc 2019;32(3):121-127. Published online July 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.3.121

Abstract PDF: PURPOSE
The study examined the fusion site and characteristics of the subtalar arthrodesis after intraarticular calcaneal fractures using computed tomography.
MATERIALS AND METHODS
The clinical results and computed tomographic analysis of the fusion site were reviewed in 18 patients who were followed-up for a minimum of six months after undergoing subtalar arthrodesis due to traumatic arthritis caused by an intra-articular calcaneal fracture from December 2012 to April 2017.
RESULTS
An evaluation of clinical results after subtalar arthrodesis revealed statistically significant improvements. In all cases, arthritis was found in the injured articular surface, which was displaced superolaterally from the initial primary fracture line of the calcaneus. Six months after arthrodesis, the subtalar fusion rate was 80.0% (16/20). Of these, 14 cases had a cannulated screw inserted in the uninjured site that is medial to the primary fracture line. Joint fusion was observed on the uninjured articular surface in 17 cases (85.0%).
CONCLUSION
Joint fusion was initially achieved at the uninjured posterior facet after subtalar arthrodesis due to traumatic arthritis caused by a displaced intra-articular calcaneal fracture. This suggests that meticulous surgical techniques and cannulated screw positioning at the uninjured site will promote joint fusion.

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Primary Subtalar Arthrodesis for the Treatment of Intra-articular Calcaneal Comminuted Fractures: Hong Geun Jung, Yu Jin Kim, Suk Ha Jeon; J Korean Fract Soc 2006;19(4):418-423. Published online October 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.4.418

PURPOSE
To evaluate the functional outcomes of the severely comminuted intra-articular calcaneal fractures that were selectively treated with primary subtalar arthrodesis.
MATERIALS AND METHODS
This study is based on the 9 patients, 10 feet of intra-articular severely comminuted calcaneal fractures that were treated with open reduction and internal fixation with primary subtalar arthrodesis due to inability to reconstruct the subtalar articular surface with follow-up of more than 1 year. Postoperative clinical evaluation was performed with AOFAS Hindfoot functional scores. The patient satisfaction, returning to previous occupation and complications were also investigated.
RESULTS
Follow-up period was average 20.3 months. Overall AOFAS functional score at final follow-up was average 71.8 points and VAS pain score was 3.9. Fifty percent of the patients were satisfied with the surgery and 80% of the patients were able to return to their previous occupations at average 8.4 months after trauma. Post-operative complications were 2 cases of sural nerve injuries and 1 hindfoot valgus malunion.
CONCLUSION
We concluded that the primary subtalar arthrodesis is a viable surgical option for severely comminuted calcaneal fractures with favorable functional result and early returning of most patients to their previous occupations.

Citations

Citations to this article as recorded by

Joint-Sparing Surgical Management of Sanders IV Displaced Intra-Articular Calcaneal Fractures
Thomas S. Roukis
Clinics in Podiatric Medicine and Surgery.2019; 36(2): 251. CrossRef
Comparative Study of Open Reduction and Internal Fixation and Primary Subtalar Arthrodesis for Sanders Type 4 Intra-Articular Calcaneal Fractures
Seung Hun Woo, Hyung-Jin Chung, Su-Young Bae, Sun-Kyu Kim
Journal of the Korean Orthopaedic Association.2017; 52(1): 49. CrossRef
Bilateral Open Transcalcaneal Fracture with Talonavicular Dislocation - A Case Report -
Hun Park, Sung Jin Shin, Sang Rim Kim, Kwang Woo Nam, Sung Wook Choi, Kyu Bum Seo, Jun Young Seo
Journal of the Korean Fracture Society.2011; 24(1): 87. CrossRef
Open Reduction and Internal Fixation with AO Calcaneal Plate for Displaced Intra-articular Calcaneal Fracture
Myung Jin Lee, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Min Soo Kang, Hyeon Jun Kim, Sang Kyu Sun
Journal of the Korean Fracture Society.2010; 23(3): 303. CrossRef

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Subtalar Distraction Arthrodesis for Calcaneal Malunion: Hyung Jin Chung, Jae Kwang Yum, Kook Jin Chung, Jae Min Jeon; J Korean Fract Soc 2006;19(1):34-40. Published online January 31, 2006; DOI: https://doi.org/10.12671/jkfs.2006.19.1.34

Abstract

PURPOSE
To evaluate the results and efficacy of the subtalar distraction arthrodesis on patients with complications due to malunion after intra-articular calcaneal fracture.
MATERIALS AND METHODS
From October 2001 to September 2004, we operated on 10 patients (14 cases). There were 9 male patients and one female; their mean age was 41 years old. Ten cases among them were operated initially. The mean period between initial injury and arthrodesis was 18 months. The mean follow up period was 16 months. During the operation, we used extensile lateral approach and arthrodesis was performed using tricortical bone block and cannulated screws. The ankle-hindfoot scale was used for clinical evaluation. In radiologic analysis, plain X-ray and CT of the both feet were examined for union and various parameters.
RESULTS
Thriteen cases achieved radiologic bone union. The mean ankle-hindfoot scale (maximum: 94 points) increased from 52.4 points preoperatively to points 77.2 at the final follow-up. The radiologic analysis of the pre and postoperative standing lateral radiograph showed mean increase of 6.9 mm in talo-calcaneal height, 5.2 degrees in talocalcaneal angle, 4.3 degrees in talar declination angle and average decrease of 4.5 degrees in talo-first metatarsal angle.
CONCLUSION
The short term result of the subtalar distraction arthrodesis using tricortical bone block was promising, but longer follow-up will be needed.

Citations

Citations to this article as recorded by

Mid-Term Follow Up Results of Subtalar Distraction Arthrodesis Using a Double Bone-Block for Calcaneal Malunion
Hyung-Jin Chung, Su-Young Bae, Ji-Woong Choo
Yonsei Medical Journal.2014; 55(4): 1087. CrossRef

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Posttraumatic avascular necrosis of talus: Soo Bong Hahn, Hong Jun Park, Kee Hong Song; J Korean Soc Fract 2000;13(2):368-374. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.368

Abstract PDF: PURPOSE
: We performed this study in order to analyze the clinical results and complications of posttraumatic avascular necrosis of talus MATERIALS AND METHODS : We performed a retrospective review of 19 patients undertaken treatment of talus fracture from September 1996 to September 1998. There were 11 males and 8 females with an a mean age of 21.4 years(range, 10-52years).
RESULTS
: In one case, there was soft tissue defect and bone maceration on dorsum of left foot due to crushing injury by traffic accident. The patient was treated with debridement and skin graft. In trauma 5 months, equinus deformity and stiffness of ankle was noted. Posttraumatic avascular necrosis of talus was noted at magnetic resonance imaging. But, there was neither collapse of talar dome nor pain. Therefore, heel cord lengthening and correction of equinus by hinged Ilizarov with distraction was done. In follow-up(1 year 3 months), avascular necrosis was improved and good ambulation without pain was possible. In another case, open reduction and internal fixation for talar neck fracture(Hawkins typeIII)was performed. In trauma 9 months, there were severe degenerative arthritis of peritalar joint, severe ankle pain, and severe avascular necrosis with collapse of talus. Therefore, dead bone resection and ankle arthrodesis with autoiliac bone graft were performed using Ilizarov external fixator. In follow-up(trauma day 1 year 11 months), good ambulation in 90degreesankle fusion state without pain was possible.
CONCLUSION
: In the treatment of talus fracture, periodic physical and radiologic examination is important for early detection of posttraumatic avascular necrosis and early management.

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Ankle Arthrodesis by Internal Fixation with Cancellous Screws and Fibula Strut Graft: Report of Two Cases: Jin Man Wang, Kwon Jae Roh, Yeo Hon Yun, Dong Jun Kim, Joo Seok Eom; J Korean Soc Fract 1997;10(3):480-484. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.480

Abstract PDF: We present two cases of ankle arthrodesis in which tibiotalar fixation was achieved by two cancellous-bone screws across the ankle joint and a lateral fibular strut graft fixed with a proximal and a distal screw. This operation is a technique described by Thordarson and his associates, who performed only an in vitro biomechanical study using fresh-frozen cadaver. Through the recent clinical trial, we could get excellent results in both of our cases. We feel the fibular strut graft provides additional stability to tibiotalar internal fixation. This technique may have a special value for those cases with poor bone quality or osteoporosis.

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Compression Arthrodesis of Ankle Joint using Autocompression Angle Plate: Eun Sun Moon, Eun Kyoo Song, Yong Gi Choi; J Korean Soc Fract 1989;2(2):174-178. Published online November 30, 1989; DOI: https://doi.org/10.12671/jksf.1989.2.2.174

Abstract PDF: We performed the compression arthrodesis in ankle joint of 4 cases, using autocompression angle plate. In all cases, we made successful union within 3 months, without any specific complications. This method gives several advantages, such as short period of external support, good cosmetic effect, early union and early rehabilitation.

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A Clinical Experience of Limited Wrist Arthrodesis (Radioscapholunate arthrodesis): Yung Khee Chung, Jung Han Yoo, Baek Yong Song; J Korean Soc Fract 1988;1(1):20-23. Published online November 30, 1988; DOI: https://doi.org/10.12671/jksf.1988.1.1.20

Abstract PDF: The principle of treatment in patient with fracture involving articular surface is necessary for anatomical reduction, rigid fixation and early motion. However, on the occasion of the unsatisfactory results such a post-traumatic arthritis of the wrist joint, in 1981, Watson and coworkers reported the good results by limited wrist arthrodesis for relief of pain and allowance of some range of motion. Recently, we have experienced two cases of post-traumatic arthritis of the wrist joint which was treated by limited wrist arthrodesis, especially, radioscapholunate arthrodesis with good results.

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