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Subtalar joint arthrodesis using a single lag screw
Andrew Haskell1, Cynthia Pfeiff, Roger Mann
1Palo Alto Medical Foundation, Palo Alto, California, USA.
Foot & Ankle International
|December 3, 2004
Summary
Subtalar joint fusion using a single lag screw is highly effective, achieving a 98% fusion rate. Prior ankle fusion delays healing, but this technique remains simple and reliable for hindfoot reconstruction.
Area of Science:
- Orthopedic Surgery
- Foot and Ankle Reconstruction
- Arthrodesis Techniques
Background:
- Subtalar joint fusion is a common procedure for various hindfoot pathologies.
- Assessing the efficacy of single lag screw fixation is crucial for surgical decision-making.
- Identifying factors influencing fusion time can optimize patient outcomes.
Purpose of the Study:
- To evaluate the effectiveness of single lag screw fixation for subtalar joint arthrodesis.
- To determine if patient-specific factors impact the time to achieve fusion.
- To establish the reliability of this surgical technique.
Main Methods:
- 101 isolated subtalar arthrodeses were performed using single lag-screw fixation (posteroinferior to anterosuperior).
- Autograft from the sinus tarsi and anterior process was used in conjunction with the screw.
- Patient demographics, smoking status, and prior ankle fusion history were recorded.
Main Results:
- An overall fusion rate of 98% was achieved, with only 2 non-unions in 101 cases.
- The average time to fusion was 12.3 weeks.
- Prior ankle fusion significantly prolonged subtalar joint fusion time (average 3 weeks delay).
Conclusions:
- Single 7.0-mm lag screw fixation across the posterior facet is a highly effective method for subtalar joint fusion (98% success rate).
- A prior ankle arthrodesis is a significant factor that delays subtalar joint fusion time.
- This technique offers a simple, reliable, and effective solution for subtalar joint arthrodesis.