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Subtalar fusion

Kun Zhang, Yanxi Chen, Minfei Qiang, Yini Hao
Single, double, and triple hindfoot arthrodeses are used to correct hindfoot deformities and relieve chronic pain. However, joint fusion may lead to dysfunction in adjacent articular surfaces. We compared range of motion in adjacent joints before and after arthrodesis to determine the effects of each procedure on joint motion. The theory of moment of couple, bending moment and balanced loading was applied to each of 16 fresh cadaver feet to induce dorsiflexion, plantarflexion, internal rotation, external rotation, inversion, and eversion...
October 18, 2016: Scientific Reports
R Lopes, M Andrieu, T Bauer
Arthroscopic subtalar arthrodesis is gaining in popularity based on evidence of bone fusion in over 90% of cases, with a shorter time to healing, a simpler postoperative course, and fewer complication compared to open surgery. Two arthroscopic techniques have been reported: one with the patient in lateral decubitus and lateral portals and the other with the patient prone and posterior portals. The objective of this technical note is to describe these two techniques, with emphasis on the specific characteristics of each...
September 26, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Amol Saxena, Rajan Patel
Locking plate fixation is becoming more popular for fixation of lower extremity osteotomies. The present study evaluated locking plate fixation compared with screw fixation in the medial displacement calcaneal osteotomy procedure, measuring the outcomes and rate of hardware removal. The procedure was performed on 30 patients, 31 times, with 17 undergoing single screw fixation and 14 undergoing locking plate fixation. The return to activity was 6.87 ± 1.43 months, including some patients for whom running was their main activity...
September 15, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Takumi Matsumoto, Richard R Glisson, Markus Reidl, Mark E Easley
BACKGROUND: Joint compression is an essential element of successful arthrodesis. Although subtalar joint compression generated by conventional screws has been quantified in the laboratory, compression obtainable with headless screws that rely on variable thread pitch to achieve bony contact has not been assessed. This study measured subtalar joint compression achieved by 2 posteriorly placed contemporary headless, variable-pitch screws, and quantified additional compression gained by placing a third screw anteriorly...
September 1, 2016: Foot & Ankle International
Ji-Cheng Gong, Bing-Hua Zhou, Xu Tao, Cheng-Song Yuan, Kang-Lai Tang
BACKGROUND: Tibiotalocalcaneal arthrodesis with headless compression screws has not been previously reported. We hypothesized that these screws could be suitable for tibiotalocalcaneal arthrodesis because of their special design. This study aimed to evaluate the clinical outcomes of patients undergoing tibiotalocalcaneal arthrodesis with headless compression screws for the treatment of severe arthropathy of the ankle and subtalar joint. METHODS: From 2010 to 2015, 23 patients with severe ankle and subtalar arthropathy underwent tibiotalocalcaneal arthrodesis...
2016: Journal of Orthopaedic Surgery and Research
Richard Walter, Stephen Parsons, Ian Winson
Arthroscopic approaches to subtalar, double, and triple arthrodesis allow relative preservation of the soft tissue envelope compared with traditional open approaches. The surgical technique involving the use of a 4.5-mm 30° arthroscope via sinus tarsi portals is described. All 3 joints of the triple joint can be prepared for fusion with motorized burrs. Rigid fixation is achieved with cannulated screws. High union rates and low complication rates have been reported.
September 2016: Foot and Ankle Clinics
Andrew J Sheean, David J Tennent, Johnny G Owens, Jason M Wilken, Joseph R Hsu, Daniel J Stinner
BACKGROUND: Fractures of the distal tibia, ankle, and foot sustained through a high-energy mechanism can be extremely debilitating, and ankle and/or subtalar fusion may be indicated if the limb is deemed salvageable. Functional outcomes among this population are often poor. The purposes of this study were to evaluate the effect of an advanced rehabilitation program combined with the use of a custom ankle-foot orthosis for patients with ankle or subtalar fusion on selected physical performance measures and patient-derived outcome measures and to determine if the response to treatment was predicated upon the type of fusion...
August 11, 2016: Foot & Ankle International
Makoto Hirao, Hideki Tsuboi, Shosuke Akita, Masato Matsushita, Shiro Ohshima, Yukihiko Saeki, Jun Hashimoto
We often see painful ankle joint destruction with painful hindfoot valgus deformity in rheumatoid arthritis. Our policy in such cases has been to first correct the hindfoot deformity in the subtalar joint with fusion, but then ankle joint pain has been observed. Two women with rheumatoid arthritis underwent correction and fusion surgery for hindfoot valgus deformity. They had been using wheelchairs because of severe pain in the ankle joint and hindfoot despite extensive medical treatment. After surgery, both patients complained of no pain in the hindfoot...
2014: SAGE Open Med Case Rep
Benwen Wu, Guofeng Huang, Zhenqi Ding
OBJECTIVE: To summarize the progress in the application of ankle and hindfoot arthrodesis. METHODS: The domestic and foreign related literature about the application of ankle and hindfoot arthrodesis was reviewed, summarized, and analyzed. RESULTS: Ankle and hindfoot arthrodesis include the multi-joint fusion and the single joint fusion, and they involve tibiotalar joint, subtalar joint, talonavicular joint, and calcaneocuboid joint. The methods of fixation include screw, plate, intramedullary nail, and external fixation...
April 2016: Chinese Journal of Reparative and Reconstructive Surgery
L Daniel Latt, Kathryn Elizabeth Smith, Kenneth Michael Dupont
: Hindfoot (tibiotalocalcaneal or TTC) arthrodesis is commonly used to treat concomitant arthritis of the ankle and subtalar joints. Simultaneous fusion of both joints can be difficult to achieve especially in patients with impaired healing due to smoking, diabetes mellitus, or Charcot neuroarthropathy. Conventional intramedullary fixation devices allow for compression to be applied at the time of surgery, but this compression can be lost due to bone resorption or settling, leading to impaired healing...
July 7, 2016: Foot & Ankle Specialist
Troy M Gorman, Timothy C Beals, Florian Nickisch, Charles L Saltzman, Mikayla Lyman, Alexej Barg
BACKGROUND: Previous hindfoot surgeries present a unique challenge to hindfoot arthrodesis, as the patients may have multiple incisions around the hindfoot. In high-risk patients with compromised soft tissues, a posterior approach can provide an alternative for a fresh soft tissue plane for the surgery. The use of a blade plate construct is widely accepted; however, there are limited data supporting the use of a posterior approach. QUESTIONS/PURPOSES: We asked (1) what proportion of patients treated with this technique achieved osseous union; (2) what complications were observed; (3) were any patient-demographic or health-related factors associated with the likelihood that a patient would have a complication develop? METHODS: Between December 2001 and July 2014, 42 patients received a posterior blade plate...
October 2016: Clinical Orthopaedics and related Research
Spencer J Monaco, Roberto A Brandao, Jeffrey M Manway, Patrick R Burns
UNLABELLED: Subtalar joint distraction arthrodesis has been well reported with use of structural iliac crest or local autologous bone graft for malunited calcaneal fractures. Early reports for structural allograft did not yield good, consistent results, leading to a subsequent lack of recommendation in previous literature. Newer studies have had promising results utilizing femoral allograft as an alternative to autogenous bone graft. We performed a retrospective chart review on 10 patients (12 feet) undergoing subtalar joint distraction arthrodesis with femoral neck allograft for malunited calcaneal fractures...
October 2016: Foot & Ankle Specialist
Kyle S Peterson, W Drew Chapman, Christopher F Hyer, Gregory C Berlet
Tibiotalocalcaneal arthrodesis is a salvage procedure for severe hindfoot/ankle deformities, arthritis, avascular necrosis of the talus, failed total ankle replacement, and Charcot neuroarthropathy. The methods for fixation include anterior and lateral plates, screws, retrograde intramedullary nails, and external fixation. The purpose of the present report was to describe the short-term radiographic outcomes and technique using a posterior approach with an anatomic-specific locking plate for tibiotalocalcaneal arthrodesis...
September 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Chamnanni Rungprai, Phinit Phisitkul, John E Femino, Kevin D Martin, Charles L Saltzman, Annunziato Amendola
BACKGROUND: Subtalar arthrodesis is a standard treatment for subtalar arthritis. Both open and arthroscopic techniques have been described and are commonly used. The cases of a consecutive series of 121 patients treated with either open or posterior arthroscopic techniques are presented with functional outcomes and complications. MATERIALS: A retrospective chart review with prospectively collected data was performed for 121 consecutive patients (129 feet) who underwent subtalar arthrodesis with open (60 feet in 57 patients) or arthroscopic (69 feet in 64 patients) techniques between 2001 and 2014...
April 20, 2016: Journal of Bone and Joint Surgery. American Volume
Jesús Vilá Y Rico, Cristina Ojeda Thies, Guillermo Parra Sanchez
Surgical fusion of the subtalar joint is a procedure indicated to alleviate pain of subtalar origin, such as in post-traumatic osteoarthritis, adult-acquired flatfoot deformity, and other disorders. Open subtalar arthrodesis has been performed with predictable results, but concerns exist regarding injury to proprioception and local vascularity due to wide surgical dissection. Minimally invasive techniques try to improve results by avoiding these issues but have a reputation for being technically demanding. We describe the surgical technique for arthroscopic subtalar arthrodesis, which has proved to be a safe and reliable technique in our experience, with consistent improvements in American Orthopaedic Foot & Ankle Society scores...
February 2016: Arthroscopy Techniques
Eric D Wicks, Melanie A Morscher, Meadow Newton, Richard P Steiner, Dennis S Weiner
PURPOSE: Triple arthrodesis is a commonly performed salvage procedure to correct hindfoot deformity. Non-union is considered an undesirable radiographic outcome; however, the clinical ramifications of this are not as well defined. The purpose of this study was to determine the incidence of partial or complete radiographic non-union after triple arthrodesis in children and characterize the clinical consequences. METHODS: An IRB-approved retrospective review of triple arthrodesis surgeries in patients less than 16 years of age performed by a single surgeon (DSW) identified 159 cases meeting the inclusion criteria...
April 2016: Journal of Children's Orthopaedics
Christopher E Gross, John S Lewis, Samuel B Adams, Mark Easley, James K DeOrio, James A Nunley
BACKGROUND: While it is thought that stresses through the subtalar and talonavicular joints will be decreased after total ankle replacement (TAR) relative to ankle fusion, progressive arthritis or deformity of these joints may require a fusion after a successful TAR. However, after ankle replacement, it is unknown how hindfoot biomechanics and blood supply may be affected. Consequently, subsequent hindfoot joint fusion may be adversely affected. METHODS: We retrospectively identified a consecutive series of 1001 primary TARs performed between January 1998 and December 2014...
July 2016: Foot & Ankle International
Federico G Usuelli, Camilla Maccario, Luigi Manzi, Christopher Edward Gross
BACKGROUND: Patients with arthritis or severe dysfunction involving both the ankle and subtalar joints can benefit from tibiotalocalcaneal (TTC) arthrodesis or total ankle replacement and subtalar fusion. TTC fusion is considered by many as a salvage operation resulting in a stiff ankle and hindfoot, considerably limiting global foot function. With the evolution of prosthetic design and operative techniques, total ankle replacement (TAR) has become a reasonable alternative to arthrodesis...
July 2016: Foot & Ankle International
Ans Van Ginckel, Sophie De Mits, Kim L Bennell, Adam L Bryant, Erik E Witvrouw
Hindfoot arthritis is an important contributor to foot pain and physical disability. Whilst the subtalar joint (STJ) is most frequently affected, anatomical variants such as facet configuration were suggested to further STJ cartilage deterioration. T2* mapping enables detection of ultra-structural cartilage change, particularly in thin cartilage layers, but its feasibility in the STJ has not yet been evaluated. The purpose of this study was to evaluate segmentation consistency and inter-scan short-term precision error of T2* mapping of talocalcaneal cartilage and to investigate the relationship between facet configuration and STJ T2* values...
February 26, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Andrew P Matson, Glenn G Shi, Selene G Parekh
UNLABELLED: Subtalar arthrodesis is considered to be the gold standard surgical solution for end-stage subtalar joint arthrosis. Although subtalar joint fusion rates are high, nonunion has been reported to range from 0% to 43%. Revision subtalar arthrodesis regardless of etiology often requires removal of loose hardware in soft bone. The inability of screw threads to engage bone may result in longer operative time, frustration for the surgeon, and potential negative outcome for the patient...
August 2016: Foot & Ankle Specialist
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