Subtalar arthrodesis for adult traumatic arthritis

In this study the effectiveness of the modified Grice extra-articular subtalar fusion in treatment of painful subtalar arthritis postintra-articular os calcis fractures was evaluated. Twenty-one patients with 23 Grice fusions returned for questioning, clinical assessment and roentgenography. There were 16 males and 5 females. The ages ranged from 20 to 69 years (average 43.3 years). The follow-up period ranged from 2 to 9 years (average 4.3 years). The back-to-work time ranged from 2 weeks to 2 years (average 6.2 months). The patients were questioned and examined according to a described rating system. The patients and surgeons rated 10 of 23 (43.5%) fusions good, 12 to 23 (52.2%) satisfactory, and 1 to 23 (4.4%) fusions unsatisfactory. Eighteen patients (85.7% were fully active, and 3 patients (13.3%) changed to lighter work or activities. All fusions were solid clinically and radiologically. Complications were few and included three mildly painful iliac crest graft donor site scars, one superficial wound infection which resolved quickly, and one foot neuroma. In summary, the modified Grice extra-articular subtalar fusion is simple, reliable, and effective in the treatment of painful traumatic subtalar arthritis.