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MINIMALLY INVASIVE SUBTALAR ARTHRODESIS USING CURETTAGE-FILLING OF THE TARSAL SINUS: 55 CASES



Abstract

Purpose: Fusion of subtalar arthrodesis is achieved in 94% of cases. There is a significant superficial cutaneous and neurological risk. Since 1985, we have performed partial arthrodesis using curettage-filling of the tarsal sinus via a minimally invasive approach. We wanted to know whether this technique decreases morbidity while preserving maximal rate of fusion.

Material and methods: We reviewed 52 patients (55 arthrodeses) operated on by the same surgeon. Immediate weight-bearing was allowed in all patients with a walking boot cast worn for ten weeks. We studied speed of fusion, the hindfoot axis, the development of complications, and the functional outcome (Kitaoka score).

Results: Fusion was not achieved in one case at ten weeks. Cutaneous necrosis occurred on one patient who had required a wide approach for other procedures. There was one superficial infection and one reflex dystrophy. Defective residual alignment was observed in six feet where the deformation could not be reduced preoperatively. The mean function score was 39/100 preoperatively and 86/94 postoperatively.

Conclusion: This technique provides excellent results with minimal morbidity but can only be proposed if the misalignment can be reduced preoperatively.

Correspondence should be addressed to SOFCOT, 56 rue Boissonade, 75014 Paris, France.