title: Predictors of Nonunion and Infectious Complications in Patients With Posttraumatic Subtalar Arthrodesis.
abstract: OBJECTIVE
  The objective of the present study was (1) to identify predictors of both nonunion and postoperative wound infections (POWI) and (2) to assess the union and complication rate following posttraumatic subtalar arthrodesis (STA).
  
  
  METHODS
  Retrospective comparative cohort study.
  
  
  METHODS
  Level 1 trauma center.
  
  
  METHODS
  All consecutive adult patients with STA following traumatic injuries between 2000 and May 2015.
  
  
  METHODS
  STA for posttraumatic deformities.
  
  
  METHODS
  Union (described as a combination of radiographic signs of osseous bridging and a clinically fused joint) and POWI as classified by the Centers for Disease and Control.
  
  
  RESULTS
  A total number of 93 (96 feet) patients met the inclusion criteria. Union was achieved in 89% of patients. For primary, secondary in situ, and secondary correction arthrodesis, these percentages were 94%, 84,% and 90%, respectively (NS). The union rate significantly increased over time (P = 0.02). In 17 patients (18%), a POWI occurred, of which 2 were classified as superficial and 15 as deep POWIs. The POWI rate did not differ between the groups. Alcohol, nicotine, and drug abuse were not significantly associated with the occurrence of POWIs. Patients with an open fracture or an infection following open reduction internal fixation had a greater risk of a POWI following STA (P = 0.03 and P = 0.04, respectively).
  
  
  CONCLUSIONS
  We could not identify predictors for nonunion. In 18% of the patients, an infectious complication following surgery occurred. Patients with an open fracture or an infection after primary surgical treatment (ie, open reduction internal fixation) have a higher chance of POWIs following STA. The union rate following posttraumatic STA is 89%.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: *Trauma-unit, Academic Medical Center, Amsterdam, the Netherlands; and †Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
authors.forename: Siem A
authors.initials: SA
authors.lastname: Dingemans
authors.forename: Manouk
authors.initials: M
authors.lastname: Backes
authors.forename: J Carel
authors.initials: JC
authors.lastname: Goslings
authors.forename: Vincent M
authors.initials: VM
authors.lastname: de Jong
authors.forename: Jan S K
authors.initials: JS
authors.lastname: Luitse
authors.forename: Tim
authors.initials: T
authors.lastname: Schepers
mesh_terms: D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000009:adverse effects*; D005260:Female; D005531:Foot Deformities, Acquired / Q000209:etiology / Q000517:prevention & control / Q000601:surgery*; D018409:Foot Injuries / Q000150:complications / Q000601:surgery*; D005597:Fractures, Open / Q000150:complications / Q000601:surgery; D005599:Fractures, Ununited / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013380:Subtalar Joint / Q000293:injuries / Q000601:surgery*; D013530:Surgical Wound Infection / Q000209:etiology*; D055815:Young Adult