PRIMARY SUBTALAR ARTHRODESIS FOR THE TREATMENT OF COMMINUTED CALCANEAL FRACTURES

We retrospectively evaluated the results of primary subtalar arthrodes is for the treatment of severely comminuted calcaneal fractures. Of 10 8 patients with 112 calcaneal fractures treated at our institution bet ween 1989 and 1992, 16 (15%) underwent primary subtalar arthrodesis th rough an extensile lateral approach. The calcaneal height and width we re restored with standard fixation techniques and then arthrodesis was performed with bone graft and fixation by 7.0-mm cannulated cancellou s screws. Fourteen patients (12 males and 2 females; mean age, 40 year s) were available for examination at a mean time of 26 months (range, 12-54 months) after surgery. Arthrodesis, evidenced by radiographic bo ny bridging across the arthrodesis site, was present in all patients b etween 8 and 12 weeks. Minor wound complications occurred in three pat ients. Of the 12 patients employed before the injury, 11 returned to t heir original occupations at a mean time of 8.8 months after injury (r ange, 1 month to 3 years). The mean AOFAS 100-point clinical rating sc ale score, evaluating pain, function, and alignment, was 72.4 points ( range, 48-88 points), We conclude that primary subtalar arthrodesis is indicated as part of the management of comminuted displaced articular calcaneal fractures, yielding results that allowed 11 of 12 formerly employed patients to return to work.