[Treatment of malunited calcaneus fracture with subtalar distraction bone block fusion].
OBJECTIVE
To report and evaluate the results of subtalar distraction bone block fusion in the treatment of malunited calcaneus fracture.


METHODS
From September 2004 to January 2008, 32 cases of malunited calcaneus fracture were treated, among which 28 cases were classified type II and 4 cases type III by Stephens-Sander's classification. Preoperative X-ray and CT examination demonstrated a talocalcaneal angle of 18.1 degrees ± 2.3 degrees , and an AOFAS score of 36.3 ± 4.1. Subtalar distraction bone block fusion was performed in all cases in this series. Regular follow-up was done with talocalcaneal angle measurement and AOFAS scoring.


RESULTS
All the 32 patients had been followed-up of 34 months, ranging from 24 to 65 months, only to reveal a primary wound healing without infection in all but one, in which superficial skin necrosis occurred postoperatively and healed after dressing-changes. Bone healing at the fusion site was seen 3 months after operation in all cases. At the final follow-up, the talocalcaneal angle was 22.9° ± 1.9° and the AOFAS score 77.5 ± 4.1, both demonstrating a significant difference (P < 0.05), when compared with those before operation.


CONCLUSIONS
Subtalar distraction bone block fusion, together with the lateral wall decompression, can correct the main deformity and reduce major symptoms induced by the malunion of calcaneus fractures, being a convenient and practical option for the treatment of malunited calcaneus fracture.
Wu
Yong
Y
Department of Traumatology, Beijing Jishuitan Hospital, Beijing 100035, China. yongwu11@126.com
Wang
Yan
Y
Wang
Jin-hui
JH
Gong
Xiao-feng
XF
Yang
Ming-hui
MH
Zhou
Da-fei
DF
Wang
Man-yi
MY
D000328:Adult; D001174:Arthrodesis / Q000379:methods*; D016025:Bone Transplantation; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D017759:Fractures, Malunited / Q000601:surgery*; D006801:Humans; D008297:Male; D013380:Subtalar Joint / Q000601:surgery*; D016896:Treatment Outcome