Sagittal Resection Osteotomy With Bone Block Distraction Subtalar Fusion for Treatment of Malunited Calcaneal Fractures |
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| Institution: | 1. Associate Professor of Orthopaedics, Alexandria University, Alexandria, Egypt;2. Consultant Orthopaedic Surgeon, Elhadara University Hospital, Elhadara, Lambrouzou, Alexandria, Egypt;3. Associate Professor of Orthopaedics, Mansoura University, Mansoura, Egypt;4. Consultant Orthopaedic Surgeon, Mansoura University Hospital, Mansoura, Egypt;5. Lecturer of Orthopaedics, Mansoura University, Mansoura, Egypt;6. Orthopedic Resident, Elhadara University Hospital, Elhadara, Lambrouzou, Alexandria, Egypt;1. Associate Consultant, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, Singapore;2. Adjunct Assistant Professor, Head of Orthopaedic Trauma Surgery Service, and Senior Consultant, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore, Singapore;1. Surgeon, AO Research Institute Davos, Davos, Switzerland;2. Assistant Professor, Department of Orthopedics and Rehabilitation, University of Florida, Gainesville, FL;3. Surgeon, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany;4. Surgeon, Department of Foot and Ankle Surgery, Catholic Clinic Mainz, Mainz, Germany;5. Professor, AO Research Institute Davos, Davos, Switzerland;6. Surgeon, Private Docent, Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany;7. Surgeon, Professor, Department of Orthopedic Trauma, University of Aachen Medical Center, Aachen, Germany;8. Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany;1. Resident, Westside Regional Medical Center, Plantation, FL;2. Board Member, Foot and Ankle Research Foundation of South Florida, Inc., Plantation, FL;3. Doctor of Medical Dentistry Candidate, Nova Southeastern College of Dental Medicine, Plantation, FL;4. Residency Director, Westside Regional Medical Center, Plantation, FL;5. Director of the Statistical Consulting Center, Nova Southeastern University, Fort Lauderdale, FL;1. Surgeon, Department of Orthopedic Surgery and Sport Trauma, University Hospital of Geneva, Geneva, Switzerland;2. Biostatician, Department of Biostatistics, Public Health and Medical Information, Groupe Hospitalier Pitié-Salpêtrière-Charles Foix, Assistance Publique-Hôpitaux de Paris, Paris, France;3. Surgeon, Department of Orthopedic Surgery and Sport Trauma, Groupe Hospitalier Pitié-Salpêtrière-Charles Foix, Assistance Publique-Hôpitaux de Paris, Paris, France;1. Professor, Division of Trauma Surgery, Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands;2. Professor, School for Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht, The Netherlands |
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| Abstract: | The aim of this prospective study was to evaluate the results of combined lateral sagittal resection osteotomy with subtalar distraction fusion in heels with painful malunion of the os calcis. This case series included 22 patients (23 feet). The mean age of the patients was 37.52 years. Sixteen (69.6%) patients were initially treated conservatively, 5 (21.7%) patients were treated surgically, and 2 (8.7%) patients were missed. The mean time lapsed before surgery was 11.43 months. A wedge of bone was resected to reduce the width of the malunited os calcis and was used as a local graft for subtalar joint fusion and to increase the height of the os calcis. The mean follow-up period was 56.83 ± 6.09 months. According to the scoring system, satisfactory results were found in 18 (82.6%) patients, and 4 (17.4%) patients had unsatisfactory results. Postoperative radiographic assessment revealed an average increase in the heel height of 7.70 ± 1.22 mm and an average decrease in heel width of 8.39 ± 1.47 mm. The average correction in the coronal axis was approximately 8.04° ± 1.26°. Complications included infection and nonunion in 3 (13%) heels. Two heels still had residual varus postoperatively, and 1 patient had injury to the sural nerve. The restoration of heel height, the reduction in heel width, and the primary fracture pattern had a significant relation with the final score. This method is a successful method for the management of subtalar arthritis caused by malunited calcaneal fractures with broadening leading to lateral abutment. |
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