title: Trephine arthrodesis of subtalar joints: operative technique and clinical effect.
abstract: 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.
authors.affiliation: Department of Orthopedic Surgery, Third People's Hospital of Jinan, Jinan, China. 6a6b6c@163.com
authors.forename: Hua-shui
authors.initials: HS
authors.lastname: Liu
authors.forename: Sheng-jun
authors.initials: SJ
authors.lastname: Duan
authors.forename: Shi-dong
authors.initials: SD
authors.lastname: Liu
authors.forename: Xin-min
authors.initials: XM
authors.lastname: Xie
authors.forename: Tao
authors.initials: T
authors.lastname: Luan
authors.forename: Lai-feng
authors.initials: LF
authors.lastname: Li
authors.forename: Jin-peng
authors.initials: JP
authors.lastname: Bu
authors.forename: Xue-chun
authors.initials: XC
authors.lastname: Zhao
mesh_terms: 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*