title: Isolated subtalar arthrodesis through minimal incision surgery.
abstract: BACKGROUND
  In recent years there has been an increase in the use of minimally invasive techniques, such as arthroscopy, percutaneous, and minimally invasive incisions, for foot and ankle surgery. The purpose of this study was to analyze the fusion rate and clinical results of isolated subtalar arthrodesis (ISA) using the novel and original technique of minimal incision surgery (MIS).
  
  
  METHODS
  There were a total of 77 feet in 76 patients who underwent ISA and were followed for 50 months on average (range, 15-108). The first 30 cases were evaluated retrospectively, and 47 cases were evaluated prospectively. MIS without tourniquet was used in all cases and fusion was assessed radiographically and clinically. Clinical outcome measures used were the Angus and Cowell Scoring System, AOFAS Ankle-Hindfoot, the SF-36, and a patient satisfaction questionnaire 12 months after the intervention.
  
  
  RESULTS
  Radiographic and clinical consolidation was achieved in 92% of cases. Main outcomes were "good" in 57 patients as determined by the Angus and Cowell criteria, with 13 "fair" and 7 "poor" results. In the prospective group, AOFAS scores improved by 47.6 points (95% CI: 50.7-42.5) 12 months after surgical intervention. SF-36 outcomes improved by 14.5 points (95% CI: 11.58-17.31) in the mental summary component and 4.2 points (95% CI: 2.2-6.1) in the physical summary component. We recorded no cases of early complications such as wound infections, neurovascular damage, or delayed wound healing.
  
  
  CONCLUSIONS
  To our knowledge, the present series represents the largest study on subtalar arthrodesis using minimally invasive surgery. The data obtained showed a similar rate of bony union and clinical outcomes compared with the literature, but without early wound complications. ISA using the MIS technique was a good option for patients at greater risk of wound healing complications.
  
  
  METHODS
  Level IV, case series.
authors.affiliation: University Hospital Virgen del Rocío, Sevilla, Spain. acarranz@us.es
authors.forename: A
authors.initials: A
authors.lastname: Carranza-Bencano
authors.forename: S
authors.initials: S
authors.lastname: Tejero-García
authors.forename: G
authors.initials: G
authors.lastname: Del Castillo-Blanco
authors.forename: J J
authors.initials: JJ
authors.lastname: Fernández-Torres
authors.forename: A
authors.initials: A
authors.lastname: Alegrete-Parra
mesh_terms: D001174:Arthrodesis / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data; D010003:Osteoarthritis / Q000601:surgery; D010146:Pain; D017060:Patient Satisfaction; D011183:Postoperative Complications; D011446:Prospective Studies; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D013380:Subtalar Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: hindfoot arthrodesis; minimal incision; minimally invasive; sequelae of calcaneus fracture; subtalar arthrodesis