Trephine arthrodesis of subtalar joints: operative technique and clinical effect.
OBJECTIVE
To review the operative technique of trephine arthrodesis of subtalar joints and evaluate its clinical effect.


METHODS
From June 1998 to October 2006, we performed subtalar arthrodesis on 38 feet of 34 patients for a variety of painful disorders of hindfoot with trephine technique. Clinical and radiologic follow-up evaluations were performed for 45 months on average (range, 21 to 110 months) after arthrodesis.


RESULTS
No severe complications were found in this study except one patient with dropfoot and two with skin necrosis. The average ankle-hindfoot scores of the American Orthopaedic Foot and Ankle Society (AOFAS) was improved from 48.3 preoperatively to 79.2 postoperatively (P<0.05). The pain scores of visual analogue scales (VAS) decreased from 7.2 (range, 3 to 10) preoperatively to 2.6 (range, 1 to 6) postoperatively (P<0.05). Subjectively, the patients experienced improvements in pain, function, cosmesis, and shoewearing. Overall, 30 patients were satisfied and all patients would have this procedure again under similar circumstances. Postoperative radiology showed that complete union was found in 35 feet 6 months after operation, with the successful union rate of 92.1%. There was an increase in arthritic scores for 5 ankles, 4 talonavicular joints, 4 calcaneocuboid joints, and 4 midfoot joints. Nonunion occurred in 3 subtalar joints with anterolateral approach, which required revision arthrodesis.


CONCLUSIONS
Isolated subtalar arthrodesis with trephine method is an effective procedure for painful malalignment of hindfoot.
Liu
Hua-shui
HS
Department of Orthopedic Surgery, Third People's Hospital of Jinan, Jinan, China. 6a6b6c@163.com
Duan
Sheng-jun
SJ
Liu
Shi-dong
SD
Xie
Xin-min
XM
Luan
Tao
T
Li
Lai-feng
LF
Bu
Jin-peng
JP
Zhao
Xue-chun
XC
D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D013380:Subtalar Joint / Q000601:surgery*