Purpose: Comparison of functional, anatomical and roenthgenological outcomes of subtalar arthrodesis technique: Ilizarov apparatus- EF and internal fixation IF.

Materials and Methods: 41 patients (31 men, 10 women) , average age of 38.8 years (12–71) with 44 symptomatic feet underwent procedures for painful arthrodeses. In 28 (30 feet) we performed subtalar arthrodeses by lateral approach, rigid internal fixation with screws.

13(14 feet) others underwent minimal invasive intervention and compression arthrodesis using Ilizarov frame. Nonweightbearing for 4–6 weeks. Removal – 8–10 weeks after the procedure.

Evaluation: subjective complaints, physical examination, postoperative radiographs. Patient suspected to have union problems underwent a CT.

Results:

In IF union rate 90% (25 patients).

Complications: Three re-arthrodeses for nonunion, entrapment of sural nerve – 2 patients, postoperative infection – 2 patients, postoperative infection – 2 patients. In one case intravenous antibiotic resolved the problem, another one needed surgical debridement. The IF overall results were excellent in 79%, good in 12%, fair in 9%.

In group EF – solid bone fusion was obtained in all patients. Pin tract infection treated in four, in one case with reinsertion of KW.

Conclusions:

Ilizarov external frame is superior for fusion.

Purpose: The purpose of this study was to clinically evaluate the efficiency of extracorporal shockwave therapy for enthesopathies.

Materials, Methods and Results: 26 patients with mean age of 51 (range: 18–73) which suffered from enthesopathies in different regions were included in this study. Prior to treatment pain and function were assessed subjectively by using a visual analog scale ranging from 1 (maximum pain/minimum function) to 10 (no pain, full function).

The follow-up period was 6–18 months with an average follow-up period of 13 months.

All patients were treated with ESWT. One to three treatment sessions were provided to each patient with an interval of one week between the sessions. After all sessions were finished, pain and function were reassessed in the same method that was used before the beginning of the treatment.

The overall mean pain value was 1.96 before the treatment and 5.92 after the treatment.

8 patients (30.7%) reported no pain at all after the treatment and in 6 patients (23%) a significant improvement in pain was achieved. 7 patients (19%) reported of only slight relief of pain and 4 patients (15.4%) reported no change in pain level. Only in one patient (3.9%) worsening of the pain was observed.

The overall mean function capacity was 5.76 before the treatment and 8.65 after the treatment. 11 patients (42%) returned to full functional capacity and in 7 patients (27%) a significant improvement in functional capacity was observed. In 8 patients (30.7%) no change in the functional capacity was noticed.

Good results of improvement in pain severity and functional capacity were observed in cases of plantar fasciitis and tennis elbow.

Conclusion: We think the EWST is helpful for treatment of enthesopathies, especially plantar fasciitis and tennis elbow, and suggest to include it in treatment algorithms.