title: Subtalar versus triple arthrodesis after intra-articular calcaneal fractures.
abstract: Depending upon initial treatment, between 2 and 30% of patients with a displaced intra-articular calcaneal fracture require a secondary arthrodesis. The aim of this study was to investigate the effect of subtalar versus triple arthrodesis on functional outcome. A total of 33 patients with 37 secondary arthrodeses (17 subtalar and 20 triple) with a median follow-up of 116 months were asked to complete questionnaires regarding disease-specific functional outcome (Maryland Foot Score, MFS), quality of life (SF-36) and overall satisfaction with the treatment (Visual Analogue Scale, VAS). Patient groups were comparable considering median age at fracture, initial treatment (conservative or operative), time to arthrodesis, median follow-up, and post-arthrodesis radiographic angles. The MFS score was similar after subtalar versus triple arthrodesis (59 vs. 56 points; P = 0.79). No statistically significant difference was found for the SF-36 (84 vs. 83 points; P = 0.67) and the VAS (5 vs. 6; P = 0.21). Smoking was statistically significantly associated with a non-union (χ(2) = 6.60, P = 0.017). The current study suggests that there is no significant difference in functional outcome between an in situ subtalar or triple arthrodesis as a salvage technique for symptomatic arthrosis after an intra-articular calcaneal fracture. Smoking is a risk factor for non-union.
authors.affiliation: Department of Surgery-Traumatology, Erasmus MC, University Medical Centre Rotterdam, Room H-822k, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands, t.schepers@erasmusmc.nl.
authors.forename: Tim
authors.initials: T
authors.lastname: Schepers
authors.forename: Brenda C T
authors.initials: BC
authors.lastname: Kieboom
authors.forename: Gert H J M
authors.initials: GH
authors.lastname: Bessems
authors.forename: Lucas M M
authors.initials: LM
authors.lastname: Vogels
authors.forename: Esther M M
authors.initials: EM
authors.lastname: van Lieshout
authors.forename: Peter
authors.initials: P
authors.lastname: Patka