[Subtalar arthrodesis--minimal resection technique].
BACKGROUND
This is a prospective clinical and radiological study of the treatment of talocalcaneal deformity or degeneration by a modified technique of isolated talocalcaneal fusion.


METHODS
Thirty-six patients were evaluated with clinical examination, plain dorso-plantar and oblique x-rays and CT-scan or magnetic resonance imaging in a follow-up of 32.5 months (range: 20-62). In 12 cases a posterior tibial tendon rupture with secondary osteoarthritis and in 24 cases a posttraumatic secondary osteoarthritis (18 calcaneal fractures, 3 talar fractures, 2 axial traumas with secondary talar necrosis and 1 rheumatoid arthritis with calcanear and talar fracture) were the indications for arthodesis.


RESULTS
On a visual analog pain scale the patients graded their pain preoperatively at 4.4 and postoperatively at 1.1. The subjective results showed in 12 cases (33.3%) complete satisfaction, in 10 cases (27.7%) satisfaction with minor reservation, in 11 cases (30.5%) satisfaction with major reservation and in 3 cases (8.5%) dissatisfaction. The overall objective results were excellent in 17 (47.2%), good in 11 (30.5%), fair in 6 (16.8%) and poor in 2 (5.5%) cases. A further advantage of this type of talocalcaneal fusion is the remaining range of motion in the neighbouring joints, at the ankle (in 75.7% the same or better ROM than preoperatively) and at Chopart joint (in 69.4% the same or better ROM than preoperatively). The fusion rate was high with 94.5%.


CONCLUSIONS
The modified isolated talocalcaneal fusion without disruption at the Chopart joint is a simple surgical technique in the hand of the experienced surgeon. The subjective and objective mid-term results of this prospective follow-up study are comparable to other technique described in literature.
Fellmann
J
J
Abteilung für Fusschirurgie, Orthopädische Universitäts-klinik Balgrist Zürich.
Zollinger
H
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods*; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007592:Joint Diseases / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D013380:Subtalar Joint / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
Subtalare Arthrodese--Minimale Resektionstechnik.