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Subtalar joint stiffness
19%
418/2198
Midfoot supination
7%
153/2198
Sinus tarsi impingement
31%
692/2198
Anterior ankle impingement
41%
909/2198
Hammertoe deformity
1%
12/2198
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The subtalar fusion technique involves distraction of the subtalar joint, insertion of a bone block, fusion, and rigid screw fixation. The distraction allows correction of the talocalcaneal relationship. In Carr’s series, pre- and postoperative radiographic analysis for tibiotalar impingement, lateral talocalcaneal angle, and talonavicular alignment was performed, with improvement to a normal range seen in the cases analyzed. Bednarz did a radiographic analysis and showed an average increase of 8 mm in hindfoot height, 9 degrees in lateral talocalcaneal angle, and 11 degrees in lateral talar declination angle. Rammelt found that compared with the unaffected side, the talocalcaneal height was corrected by 61.8%, the talus-first metatarsal axis by 46.5%, the talar declination angle by 38.5% and the talocalcaneal angle by 35.4%. Based on these three references, this procedure ultimately addresses the lost hindfoot height, subtalar arthritis (joint is fused), ankle impingement (improvement of the talus 1st MT axis), and peroneal impingement. It does not address hindfoot valgus. However, the deformity after a calcaneus fracture is usually from lateral wall blowout and hindfoot varus. Illustration A shows a lateral radiograph of a distraction/bone block subtalar arthrodesis.
3.2
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