Screws-Only Primary Subtalar Arthrodesis for Calcaneus Fractures

Area of Science:

• Orthopedic surgery
• Traumatology
• Foot and ankle surgery

Background:

• Displaced intraarticular calcaneus fractures (DIACFs) present management challenges.
• Open reduction internal fixation (ORIF) often yields disappointing outcomes.
• ORIF with primary subtalar arthrodesis (PSTA) is an increasingly favored alternative.

Purpose of the Study:

• To evaluate patient-centered and radiographic outcomes of ORIF with PSTA using only screws.
• To assess the efficacy of the sinus tarsi approach for DIACFs treated with PSTA.

Main Methods:

• Retrospective study of 79 DIACFs treated with ORIF + PSTA using screws exclusively.
• Exclusion of delayed surgeries (past 8 weeks).
• Data collection included demographics, worker's compensation claims, and radiographic outcomes.

Main Results:

• 86.1% of fractures achieved radiographic fusion; 57.3% fused in all three locations.
• Median time to weightbearing was 57.5 days.
• 9 of 14 worker's compensation patients returned to work; 11 fractures did not achieve union.

Conclusions:

• Screws-only PSTA via a sinus tarsi approach is associated with good radiographic fusion rates.
• This technique demonstrates a relatively high rate of return to work for patients with DIACFs.
• Further investigation may be warranted to optimize outcomes and minimize non-union rates.