title: [Subtalar arthrodesis].
abstract: OBJECTIVE
  Realignment and stabilization of the hindfoot by subtalar joint arthrodesis.
  
  
  METHODS
  Idiopathic/posttraumatic arthritis, inflammatory arthritis of the subtalar joint with/without hindfoot malalignment. Optional flatfoot/cavovarus foot reconstruction.
  
  
  METHODS
  Inflammation, vascular disturbances, nicotine abuse.
  
  
  METHODS
  Approach dependent on assessment. Lateral approach: Supine position. Incision above the sinus tarsi. Exposure of subtalar joint. Removal of cartilage and breakage of the subchondral sclerosis. In valgus malalignment, interposition of corticocancellous bone segment; in varus malalignment resection of bone segment from the calcaneus. Reposition and temporarily stabilization with Kirschner wires. Imaging of hindfoot alignment. Stabilization with cannulated screws. Posterolateral approach: Prone position. Incision parallel to the lateral Achilles tendon border. Removal of cartilage and breakage of subchondral sclerosis. Medial approach: Supine position. Incision just above and parallel to the posterior tibial tendon. Removal of cartilage and breakage of subchondral sclerosis. Stabilization with screws.
  
  
  METHODS
  Lower leg walker with partial weightbearing. Active exercises of the ankle. After a 6‑week X‑ray, increase of weightbearing. Full weightbearing not before 8 weeks; with interpositioning bone grafts not before 10-12 weeks. Stable walking shoes. Active mobilization of the ankle.
  
  
  RESULTS
  Of 43 isolated subtalar arthrodesis procedures, 5 wound healing disorders and no infections developed. Significantly improved AOFAS hindfood score. Well-aligned heel observed in 34 patients; 5 varus and 2 valgus malalignments. Sensory disturbances in 8 patients; minor ankle flexion limitations. Full bone healing in 36 subtalar joints, pseudarthrosis in 4 patients.
authors.affiliation: Klinik für Fuß- und Sprunggelenkchirurgie, Rhön-Klinikum, Salzburger Leite 1, 97616, Bad Neustadt, Deutschland. ReneeAndrea.Fuhrmann@fusschirurgie-bad-neustadt.de.
authors.forename: R A
authors.initials: RA
authors.lastname: Fuhrmann
authors.affiliation: Klinik für Handchirurgie, Rhön-Klinikum, Bad Neustadt, Deutschland.
authors.forename: T
authors.initials: T
authors.lastname: Pillukat
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods* / Q000534:rehabilitation; D001863:Bone Screws; D001864:Bone Wires; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005413:Flatfoot / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013380:Subtalar Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Arthrodesis; Cavovarus foot; Flatfoot; Hindfoot; Lower ankle joint; Subtalar joint