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Risk Factors for Subtalar Arthrodesis Following Calcaneus ORIF: A Temporal Analysis Using a Large Database.

Samuel A Florentino1, Alexander N Berk1, Logan M Good1

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PubMed
Summary
This summary is machine-generated.

Subtalar arthrodesis (STA) after calcaneus fracture surgery is linked to obesity, hypertension, and nicotine use. Identifying these risk factors can guide better patient management and surgical decisions for calcaneus open reduction and internal fixation (ORIF).

Keywords:
calcaneus ORIFcalcaneus fracturesubtalar arthritissubtalar arthrodesis

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Biostatistics

Background:

  • Subtalar arthrodesis (STA) is a recognized complication following calcaneus open reduction and internal fixation (ORIF).
  • Predictive factors and optimal timing for STA after ORIF remain incompletely understood.
  • Existing data on patient demographics and predictors for STA post-ORIF are limited.

Purpose of the Study:

  • To identify risk factors, timing, and patient characteristics associated with STA after calcaneus ORIF.
  • To inform risk stratification and postoperative management strategies for patients undergoing calcaneus ORIF.
  • To evaluate the influence of sociodemographic factors on STA occurrence.

Main Methods:

  • Retrospective cohort study utilizing the TriNetX US Collaborative Network database (2004-2023).
  • Inclusion of patients aged 18+ who underwent operative treatment for calcaneus fractures.
  • Comparison of baseline demographics and comorbidities between patients who did and did not undergo subsequent STA; analysis of STA timing (0-2, 2-5, >5 years post-ORIF).

Main Results:

  • Out of 11,640 patients receiving calcaneus ORIF, 431 (3.7%) subsequently underwent STA.
  • The majority of STAs (70%) occurred within 2 years post-ORIF.
  • Significant risk factors for STA included obesity, nicotine dependence, hypertension, psychiatric disorders, and divorced status; Black or African American race was associated with lower STA likelihood.

Conclusions:

  • Obesity, hypertension, nicotine dependence, psychiatric disorders, and marital status are significant risk factors for STA post-calcaneus ORIF.
  • Modifiable risk factors like obesity, hypertension, and nicotine dependence necessitate patient counseling and risk mitigation.
  • Consideration of primary arthrodesis in high-risk individuals and individualized, equitable surgical decision-making are emphasized.