title: Comparison of cannulated screws versus compression staples for subtalar arthrodesis fixation.
abstract: BACKGROUND
  Different fixation techniques have been described in the literature for isolated subtalar arthrodesis (ISA). The purpose of this study was to compare the fusion rate and clinical outcome of ISA using cannulated compression screws or compression staples.
  
  
  METHODS
  Thirty-three patients (33 feet) underwent ISA using screw (17 feet) or staples (16 feet) fixation. Patients were followed for 42.7 ± 16.4 months (range, 24.5-84.3 months). The subtalar fusion was assessed radiographically and clinically. Clinical outcome measures included the visual analog scale (VAS) for pain and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score.
  
  
  RESULTS
  The average pain score decreased significantly from 6.4 ± 1.1 (range, 5-9) to 0.8 ± 1.3 (range, 0-4) (P < .001). In the screws group, the average AOFAS hindfoot score increased significantly from 54.6 ± 8.8 (range, 37-67) preoperatively to 86.1 ± 7.1 (range, 71-91) postoperatively (P < .001). In the staples group, the average AOFAS hindfoot score increased significantly from 53.4 ± 11.1 (range, 33-69) preoperatively to 83.4 ± 6.9 (range, 71-91) postoperatively (P < .001). The AOFAS hindfoot score was comparable in both groups (P = .149). Only the AOFAS hindfoot score function subgroup in the screw fixation was significantly higher than in the staples fixation group (P = .005). There were 4 cases of nonunion at the site of subtalar arthrodesis (2 from screws group, 2 from staples group). The complication rate was comparable in both groups.
  
  
  CONCLUSIONS
  The fusion rate was comparable in both groups, while the postoperative functional outcome was significantly better in the screw fixation group.
  
  
  METHODS
  Level III, retrospective comparative cohort study.
authors.affiliation: Orthopaedic Department, University Hospital of Canary Islands, La Laguna, Tenerife, Spain.
authors.forename: Mario
authors.initials: M
authors.lastname: Herrera-Pérez
authors.affiliation: Orthopaedic Department, University Hospital of Canary Islands, La Laguna, Tenerife, Spain.
authors.forename: Cesar
authors.initials: C
authors.lastname: Andarcia-Bañuelos
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland alexej.barg@usb.ch herrera42@gmail.com.
authors.forename: Alexej
authors.initials: A
authors.lastname: Barg
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Wiewiorski
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors.forename: Victor
authors.initials: V
authors.lastname: Valderrabano
authors.affiliation: Orthopaedic Center, University of Utah, Salt Lake City, UT, USA.
authors.forename: Ashley L
authors.initials: AL
authors.lastname: Kapron
authors.affiliation: Orthopaedic Department, University Hospital of Basel, Basel, Switzerland.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: De Bergua-Domingo
authors.affiliation: Orthopaedic Department, University Hospital of Canary Islands, La Laguna, Tenerife, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Pais-Brito
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods*; D001863:Bone Screws; D005260:Female; D006801:Humans; D016268:Internal Fixators / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D012189:Retrospective Studies; D013380:Subtalar Joint / Q000601:surgery*; D013537:Sutures
keywords: isolated subtalar arthrodesis; screws fixation; staples fixation; subtalar osteoarthritis; union rate