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International Orthopaedics

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01-07-2017 | Original Paper

Fusion of the subtalar joint for post-traumatic arthrosis: a study of functional outcomes and non-unions

Authors: Patrick Ziegler, Jan Friederichs, Sven Hungerer

Published in: International Orthopaedics | Issue 7/2017

Abstract

Background

The aim of this prospective cohort study was to quantify the rate of non-unions after arthrodesis of the subtalar joint, to identify risk factors and to evaluate the functional outcome.

Methods

Patients with subtalar fusion from 2000 to 2013 and pre-existing post-traumatic osteoarthritis of the subtalar joint were analysed for risk factors like revision surgery, infection history in the area of operation, obesity, diabetes, cigarette smoking and alcohol abuse. The osseous consolidation was proven by x-ray or CT-scan and clinical aspects, e.g. consistent pain or functional disorders. The outcome was measured using the AOFAS hindfoot score, the SF-36 score and additionally by the visual analog scale. This study included 214 patients with 267 operations (n = 214, age 49 ± 12 years, 83% men); 59% of the cases had a calcanear fracture (n = 126).

Results

Non-unions were substantially high with 23.8%, including all risk factors whereas the non-union rate without any risk factors was only 12%. Considering revision surgery, there were no remarkable differences in the rate of non-union.

Infections showed an odds ratio for non-union of 4.33 compared to patients without any risk factors. The AOFAS hindfoot score showed 49 ± 20 after primary arthrodesis and 46 ± 17 after secondary arthrodesis.

Conclusion

Failure of subtalar fusion after post-traumatic osteoarthritis is attributable to various examined risk factors. The presence of an infection was stated as a major negative predictive factor for osseous consolidation. Especially the summation of risk factors increases the chance for non-union.

Level of evidence: Level II Prospective Comparative Study.

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Title: Fusion of the subtalar joint for post-traumatic arthrosis: a study of functional outcomes and non-unions
Authors: Patrick Ziegler
Jan Friederichs
Sven Hungerer
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 7/2017
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-017-3493-3

At a glance: The STEP trials

Springer Medicine

Fusion of the subtalar joint for post-traumatic arthrosis: a study of functional outcomes and non-unions

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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