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Arthroscopic debridement of the subtalar joint and subfibular recess with in situ subtalar joint arthrodesis
6%
102/1837
Distraction bone block subtalar arthrodesis
75%
1376/1837
Tibiotalocalcaneal arthrodesis
11%
203/1837
Corrective intra-articular osteotomy of the calcaneus
4%
67/1837
Arthroscopic debridement of the subtalar joint and subfibular recess with lateral distraction opening wedge calcaneal osteotomy
78/1837
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The complex pathology in this scenario includes: incongruous subtalar joint, loss of calcaneal body height, and likely decreased lateral talocalcaneal angle. Complications of this injury include pain, shoe wear difficulties, and foot deformity. Foot deformity (collapse of the talus into the posterior facet) can result in tibiotalar neck impingement. Carr et al described a subtalar fusion technique for late complications of calcaneus fractures that were treated conservatively. The subtalar fusion technique involves distraction of the subtalar joint, insertion of a bone block, and rigid screw fixation. The distraction allows correction of the talocalcaneal relationship and regains lost hindfoot height. (A subtalar fusion would address the pain issue but not the other factors). Chandler et al states that distraction arthrodesis should be considered only if findings of anterior ankle impingement are present, as is true in this case.
3.9
(23)
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