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General Orthopaedics

ARTHROSCOPIC SUBTALAR FUSION: RESULTS OF A SERIES OF 33 ISOLATED SUBTALAR ARTHRODESES

12th Combined Meeting of the Orthopaedic Associations (AAOS, AOA, AOA, BOA, COA, NZOA, SAOA)



Abstract

Background

Subtalar fusion is traditionally an open procedure with potentially significant complications but there is little published on arthroscopic subtalar arthrodesis.

Methods

We present the first UK series of 33 arthroscopic subtalar fusions in 32 patients, with a variety of pathologies

Results

There were 14 males and 18 females operated on between March 2004 and February 2009. Patients with previous hindfoot fusions were excluded as were patients who underwent combined arthroscopic hindfoot fusions. All patients had surgery by the senior author and followed an identical post-operative management plan. No patients were lost to follow-up. Successful outcome was taken as clinical and radiological evidence of fusion. We report a 100% union rate with 75.8% [25/33] union by 12 weeks, 97% [32/33] by 16 weeks with a single outlier achieving fusion at 22 weeks. There were no wound breakdowns, deep infections, neuromas or thrombotic events. Two patients required removal of metalwork. One patient developed mild CRPS and a further patient became symptomatic from concomitant calaneo-cuboid and talo-navicular joint arthrosis.

Discussion

Previous authors have reported variable complication rates and significant rates of delayed and non-unions following open subtalar fusion. This technique respects the soft tissue envelope and therefore is less traumatic to the hindfoot. Our early results suggest that isolated arthroscopic subtalar fusion is a safe and reliable technique, even in patients with deformity, with an excellent union rate and minimal complications.


M Butler, Tranquil Cross, South Drive, Tehidy, Camborne TR14 0EZ, UK