LATE RESULTS OF SUBTALAR DISTRACTION FUSION

Between 1990 and 1994, 15 subtalar distraction fusions were performed on 14 patients for sequelae of calcaneus fractures. Twelve patients (1 3 feet) were available for a minimum P-year follow-up and constituted the composition of this study. All patients complained of lateral ankl e pain and had CT evidence of calcaneofibular abutment and radiographi c evidence of loss of heel height preoperatively. The average age at t ime of surgery was 56 years (range, 23-81 years), and the average foll ow-up was 47 months (range, 25-75 months). The only change in surgical technique from that previously described was the use of a bone spread er rather than a femoral distracter for distraction of the subtalar jo int. The average preoperative talocalcaneal angle improved from 27 deg rees (range, 19-37 degrees) to 33 degrees (range, 23-45 degrees) posto peratively (P < 0.003). The mean talar declination angle improved from 11 degrees (range, 6-18 degrees) to 16 degrees (range, 7-27 degrees) postoperatively (P < 0.003), The mean heel height increased from 71 mm (range, 60-83 mm) to 76 mm (range, 63-91 mm) postoperatively (P < 0.0 001), All patients completed the AOFAS Ankle-Hindfoot scale at latest follow-up, and the average score was 76.1 (range, 57-94). Eleven of 13 outcomes were rated as very satisfactory or satisfactory. Twelve of 1 3 said they would 'definitely yes'' do surgery again, We have found th at subtalar distraction fusion for late complications of calcaneus fra cture in a carefully selected population can provide a consistent and satisfactory outcome.