Subtalar arthroscopy augments intraoperative fluoroscopy in anatomic reduction of the posterior calcaneal facet of the subtalar joint and is most useful for Sanders type II, AO-OTA 83-C2 fractures. The percutaneous approach further avoids soft tissue complications associated with open reduction. However, this procedure has a steep learning curve, and conversion to open reduction must be considered when percutaneous reduction fails.

Preoperative diagnosis is difficult but it is important for discussion of the extent and options of surgery. Fine-needle aspiration cytology holds promise in making a preoperative diagnosis. Enucleation with nerve preservation where possible seems to offer better facial function whereas nerve excision with cable graft can give satisfactory results.

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