Isolated Subtalar Arthrodesis

摘要: Background: The purposes of this retrospective study were to review the results isolated subtalar arthrodesis in adults and identify factors influencing union rate. hypotheses that (1) overall outcome is acceptable but not as favorable previously reported, (2) complication rates, especially nonunion rate, are higher than (3) contributing a less rate can be identified. Methods: Between January 1988 July 1995, 184 consecutive arthrodeses performed 174 (115 men fifty-nine women) whose average age was forty-three years (range, eighteen seventy-nine years). Eighty patients (46 percent) smokers. indications for procedure included posttraumatic arthritis after fracture calcaneus (109 feet), talus (thirteen or dislocation feet); primary failure previous (twenty-eight residual congenital deformity (eight feet). Rigid internal fixation with one two screws used all feet. Bone graft 145 feet; types material cancellous autograft (ninety-four structural (twenty-nine allograft (seventeen (five remaining thirty-nine feet. Results: Clinical radiographic follow-up examinations 148 (80 feet at an fifty-one months twenty-four 130 months) postoperatively. ankle-hindfoot score according modified scale American Orthopaedic Foot Ankle Society (maximum possible score, 94 points) improved from 24 points preoperatively 70 follow-up. Thirty had clinical evidence nonunion. 84 percent (154 184) overall, 86 (134 156) arthrodesis, 71 (twenty twenty-eight) revision arthrodesis. 92 (ninety-three 101 feet) nonsmokers 73 (sixty-one eighty-three smokers (p < 0.05). Intraoperative inspection revealed 42 (seventy-eight) more millimeters avascular bone joint; thirty nonunions occurred group A three five been treated six which adjacent site ankle After elimination subgroups who smoked, those graft, 96 (seventy-three seventy-six). Complications other prominent hardware requiring screw removal (thirty-six 20 percent), lateral impingement (fifteen 10 symptomatic valgus malalignment 3 varus (four infection percent). Conclusions: To best our knowledge, present includes largest reported series adults. Our suggest following has studies. significantly diminished by smoking, presence site, 0.05 all). Other probably affect include use performance