Level of Clinical Evidence: 4Keywords: ankle arthroscopy posterior subtalar arthroscopy subtalar arthritis subtalar arthrodesis a b s t r a c t Arthroscopic subtalar arthrodesis has recently gained popularity in the treatment of primary subtalar or posttraumatic arthritis, coalition, or inflammatory diseases with subtalar arthritis. The present study reports the clinical and radiologic results of 19 patients (19 feet) who underwent posterior arthroscopic subtalar arthrodesis using 2 posterior portals. A total of 19 posterior arthroscopic subtalar arthrodeses (minimum follow-up of 24 months) performed without a bone graft and with 2 parallel screws were prospectively evaluated. The fusion rate was 94% (mean time to fusion 9.8 weeks). Modified American Orthopaedic Foot and Ankle Society anklehindfoot scale score (maximum 94 points) improved significantly from 43 to 80 points and the visual analog scale for pain score improved from 7.6 to 1.2. The 12-item short-form physical and mental scores at the last follow-up point were 52.5 and 56.4, respectively. One (5.3%) patient underwent open repeat fusion for nonunion, 2 (10.5%) patients required a second procedure for implant removal, and 1 (5.3%) experienced reversible neuropraxia. In conclusion, posterior arthroscopic subtalar arthrodesis is a safe technique with a good union rate and a small number of complications in patients with no or very little hindfoot deformity.
Surgical treatment of calcaneal fractures continues to be a challenge for surgeons owing to the high risk of complications. The aims of this study were to analyze the results of percutaneous locking nail fixation, including radiologic and functional outcomes, complications, time to surgery and to hospital discharge. This is a retrospective study, that assessed calcaneal fractures treated with a percutaneous locking nail (Calcanail, FH Orthopedics). The fractures were classified according to Sanders. Pain, function and range of motion were evaluated at final follow up, according to the visual analogue scale (VAS), the foot and Ankle Outcome Score (FAOS) and the American Orthopaedic Foot and Ankle Society Ankle-Hind foot Score (AOFAS-AHS), respectively. Between July 2016 and May 2018, 12 patients and 13 fractures were identified. The mean time to surgical procedure was 10.5 days, with 1 day of hospital stay. The average AOFAS and FAOS scores were 87.8 and 79.2% respectively, at a mean final follow-up of 16 months, and the mean VAS was 1.83/10. Böhler and Gissane angles improved from 18º and 132º to 28º and 122º respectively. The mean improve of calcaneal height was 0.5 cm. The mean time to return to daily activity level was 3.3 months and to work 4 months. 8% of the patients had complications severe enough to require a new intervention, and we had no skin complications. Percutaneous calcaneal fracture fixation with locking nail appears to be an effective and reliable procedure. It is a surgical option in selected patients.
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