SUBTALAR DISTRACTION BONE BLOCK FUSION - AN ASSESSMENT OF OUTCOME

Twenty-nine feet in 28 patients who underwent subtalar distraction bon e block fusion for the treatment of subtalar deformities associated wi th symptomatic arthrosis were evaluated. All patients were assessed wi th the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindf oot Scale score. Eighteen men and 10 women with a mean age of 44 years were evaluated. The mean follow-up was 33 months. Subtalar arthrosis was secondary to trauma in 27 of 29 feet (93%) with os calcis fracture s in 19, subtalar dislocations in 5, and tarus fractures in 3. Eightee n of the 28 patients (64%) returned to either full- or part-time work. The change in the mean AOFAS Ankle-Hindfoot Scale score from 25 preop eratively to 75 postoperatively was statistically significant (P < 0.0 001). The radiographic analysis of the pre-and postoperative stan ding lateral radiographs showed an average increase of 8 mm in hindfoot he ight, 9 degrees in lateral talocalcaneal angle, and 11 degrees in late ral talar declination angle that were statistically significant (P < 0 .0001). All patients but one (96%) were satisfied. Complications inclu ded four nonunions, two varus malunions, one metatarsal stress fractur e, and one medial planter nerve paresthesia. Each nonunion occurred in patients who smoked.