Functional outcome of subtalar arthrodesis using double lag screw technique

Abstract

Background: This study evaluated the functional result of subtalar joint fusion and effectiveness of a technique using double lag screw from posteroinferior calcaneus to talus in post traumatic subtalar arthritis following the calcaneal intra-articular fracture. Materials and Methods: In between January 2012 and August 2013, we performed 10 isolated subtalar arthrodesis by double lag screw technique from posteroinferior calcaneus to talus, across posterior facet of subtalar joint, after denuding the joint cartilage, combined with application of an autograft taken from iliac crest, by open method. The average patient age was 47 (range 35-60) year. There were 7 male and 3 female. The indication was the pain following the post-traumatic arthritis of subtalar joint in intra-articular fracture of posterior facet of calcaneus. Result: All 10 joints were fused except one who undergone delayed fusion because of infection, resulting in an overall fusion rate of above 90%. The average time to fusion was 12.3+/−3.4 weeks. The fixation screw was removed in 2/10 joint at an average of 8.8+/−0.5 month. Conclusion: Using the double lag screws of 6.5mm across the posterior facet of subtalar joint resulted in fusion of joint in above 90% of patients. The relief from pain was obtained in 100% of cases. This is a simple and reliable technique for achieving fusion of subtalar joint.

Keywords

• arthrodesis
• bone graft
• corticocancellous screw
• subtalar joint