Hindfoot Injuries: How to Avoid Posttraumatic Varus Deformity?

Area of Science:

• Orthopedic surgery
• Trauma surgery
• Foot and ankle reconstruction

Background:

• Posttraumatic hindfoot varus is a potential complication following inadequate treatment of talar and calcaneal fractures.
• Malreduction and fixation issues can lead to significant hindfoot deformity.

Purpose of the Study:

• To outline essential surgical considerations for preventing and managing posttraumatic hindfoot varus.
• To emphasize critical steps in the operative treatment of talar and calcaneal fractures.

Main Methods:

• Highlighting the importance of bilateral surgical approaches for optimal talar neck visualization.
• Discussing the avoidance of lag screws in medial talar neck comminution, favoring plate fixation.
• Detailing the use of a Schanz screw for calcaneal deformity correction.

Main Results:

• Adequate visualization of the talar neck is key to preventing malreduction.
• Specific fixation strategies, such as avoiding lag screws in comminuted fractures and using plates, are recommended.
• Calcaneal osteotomies and fixation techniques can correct heel deformities.

Conclusions:

• Meticulous surgical technique, including visualization and appropriate fixation, is vital to prevent posttraumatic hindfoot varus.
• Addressing medial facet impaction of the talus and calcaneus is critical for successful hindfoot alignment.
• Surgical management requires careful attention to detail to achieve optimal outcomes in complex hindfoot fractures.