[Subtalar arthrodesis and calcaneal thalamus reconstruction for malunion of calcaneal fractures].

OBJECTIVE: To evaluate the clinical results of subtalar arthrodesis and calcaneal thalamus reconstruction for malunion of calcaneal fractures and to discuss the indications and its advantages of the management.

METHODS: From December 1994 to January 2006, 84 cases (96 feet) of malunion of calcaneal fractures were treated with subtalar arthrodesis and calcaneal thalamus reconstruction. The L-shaped approach lateral to calcaneus was used. The bone autograft was harvested from iliac crest. Fifty-one cases were male and 33 cases were female, aging from 21 to 58 years (mean 38.5 years). One side was in volved in 72 cases and two sides in 12 cases. The injury was caused by falling from height in 57 cases, by traffic accident in 22 cases and other in 5 cases. It was 6-31 months from injury to operation (mean 9.5 months).

RESULTS: Among the patients, all cases were followed up 1 to 132 months. The total excellent and good rate was 87.5% including excellent in 31 feet, good in 53 feet and fair in 12 feet,according to Hindfoot scores system (American Orthopaedics Foot and Ankle Society). The Bohler's and Gissane's angles, the height of calcaneal thalamus and width of calcaneus were significant different from those of preoperation (P < 0.01).

CONCLUSION: The treatment by bone autograft combined with subtalar arthrodesis and calcaneal thalamus reconstruction is an effective operation for malunion of calcaneal fractures, with advantages of correcting deformity, restoring the function of hindfoot and relieving the pain of walking.