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.

Peritalar Dislocations or Fracture-Dislocations: Seung Koo Rhee, Hwa Sung Lee, Jong Bum Park, Jin Wha Chung, Eui Yong Um, Whi Ju Whang; J Korean Soc Fract 2001;14(4):689-697. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.689

Abstract PDF: PURPOSE
To find the proper way and timing of treatment for minimizing the posttraumatic complication of peritalar dislocation or fracture-dislocation.
MATERIALS AND METHODS
We reviewed total 12 cases of peritalar dislocation or fracture-dislocation that consist of 9 cases of subtalar joint dislocations, I case of talonavicular joint dislocation and 2 cases of talar fracture-dislocations. Closed reduction was performed for subtalar dislocation without suturing the torn ligaments. The average follow up period was 25 months.
RESULTS
Of 9 subtalar dislocations, 8 cases presented acceptable results. But 1 case of a 28-year-old male patient with prolonged heavy sports activity history presented pain and mild limping. The other 3 cases of talo-navicular joint dislocation and talar fracture-dislocations presented acceptable results except one complaining of scar contracture.
CONCLUSION
Complications such as early skin necrosis or neurovascular damage could be prevented by early closed reduction for peritalar dislocations or fracture dislocations, and the repair of torn ligaments of ankle joint in peritalar dislocations did not affect the end results.

Occult Fractures of the Subtalar Joint: Chong Hyuk Choi, Seong Jin Park, DJ Ogilvie Harris; J Korean Soc Fract 2000;13(4):935-940. Published online October 31, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.4.935

Abstract PDF: The purpose of the current study was to investigate the results of occult fractures in the subtalar joint which were detected in delay and to find out a way of early detection. The occult osteochondral fractures of the subtalar joint are known to be associated with dislocation and to have a poor prognosis. We treated ten patients who had the occult fractures that were not associated with dislocation. Nine fractures involved posterior facet with a displaced osteochondral fracture. Seven patients lost motion in the subtalar joint completely, and arthrodesis were performed. Three subtalar joints retained some motion and were treated with physiotherapy, which improved the movement and pain. The early detection of fracture was important for the prognosis. We note the "early warning"signs of the patients who have massive swelling without definite bone injury, and who had a failure to regain the subtalar motion after immobilization. The subtalar joint should be imaged with CT or MRI. At first, aggressive physiotherapy should be considered. Arthrodesis should be considered as a final option.

Interlocking Intramedullary Nail Fixation for Tibiotalocalcaneal Fusion(2 cases): Young Ki Chung, Jung Han Yoo, Sung Il Shin, Yong Wook Park, Dong Cheol Pyo; J Korean Soc Fract 1997;10(4):860-865. Published online October 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.4.860

Abstract PDF: Multiple fixation techniques for tibiotalocalcaneal arthrodesis have been introduced. The interlocking intramedullary nailing for tibiotalocalcaneal osteoarthritis with osteoporosis permits excellent internal fixation. We had two retrograde interlocking intramedullary nail fixation for tibiotalocalcaneal arthrodesis. One patient is chronic infectious osteoarthritis of the ankle and subtalar joints. And the other is non-union of the distal tibia with arthrofibrosis of the ankle and subtalar joints. Two patients also had osteoporosis due to long immobilization. The follow up period were 12 and 22 months respectively. The leg and foot is aesthetically pleasing and the musculature around the ankle and foot is maintained in the normal balanced position after the tibiotalocalcaneal fusion. So, we believed that the interlocking intramedullary nailing is an excellent treatment method for tibio talocalcaneal arthritis with osteoporosis.

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