Application and research progress of subtalar distraction bone block arthrodesis in treatment of calcaneus fracture malunion_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANG Shanxi , LI Jun , HUANG Fuguo ,  LIU Lei

Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

LIU Lei, Email: liuinsistence@163.com

Keywords：

Calcaneus fracture malunion; subtalar distraction arthrodesis; bone block graft

DOI：

10.7507/1002-1892.201611058

Video：

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Objective To review the application and research progress of subtalar distraction bone block arth-rodesis in the treatment of calcaneus fracture malunion. Methods The recent literature concerning the history, surgical technique, postoperative complication, indications, and curative effect of subtalar distraction arthrodesis with bone graft block interposition in the treatment of calcaneus fracture malunion was summarized and analyzed. Results Subtalar distraction bone block arthrodesis is one of the main ways to treat calcaneus fracture malunion, including a combined surgery with subtalar arthrodesis and realignment surgery for hindfoot deformity using bone block graft. The advantage is on the base of subtalar joint fusion, through one-time retracting subtalar joint, the posterior articular surface of subtalar joint implants bone block can partially restore calcaneal height, thus improving the function of the foot. Compared with other calcaneal malunion treatments, subtalar distraction arthrodesis is effective to correct complications caused by calcaneus fracture malunion, and it can restore the height of talus and calcaneus, correct loss of talocalcaneal angle, and ease pain. Conclusion Subtalar distraction bone block arthrodesis has made remarkable progress in the treatment of calcaneus fracture malunion, but it has the disadvantages of postoperative nonunion and absorption of bone block, so further study is needed.

Citation： WANG Shanxi, LI Jun, HUANG Fuguo, LIU Lei. Application and research progress of subtalar distraction bone block arthrodesis in treatment of calcaneus fracture malunion. Chinese Journal of Reparative and Reconstructive Surgery, 2017, 31(6): 755-759. doi: 10.7507/1002-1892.201611058 Copy

1.	Jackson JB 3rd, Jacobson L, Banerjee R, et al. Distraction subtalar arthrodesis. Foot Ankle Clin, 2015, 20(2): 335-351.
2.	Schepers T. The subtalar distraction bone block arthrodesis following the late complications of calcaneal fractures: A systematic review. Foot (Edinb), 2013, 23(1): 39-44.
3.	周孝辉, 任玉清. 跟骨截骨矫形距下关节植骨融合术治疗严重跟骨骨折畸形愈合的手术方法及临床疗效. 世界最新医学信息文摘(电子版), 2016, (14): 92-93.
4.	李东风, 李先启, 燕志远, 等. 距下关节牵开植骨融合术治疗跟骨骨折畸形愈合的效果. 中国继续医学教育, 2015, 7(31): 113-115.
5.	Clare MP, Lee WE 3rd, Sanders RW. Intermediate to long-term results of a treatment protocol for calcaneal fracture malunions. J Bone Joint Surg, 2005, 87(5): 963-973.
6.	Amendola A, Lammens P. Subtalar arthrodesis using interposition iliac crest bone graft after calcaneal fracture. Foot Ankle Int, 1996, 17(10): 608-614.
7.	Chung HJ, Bae SY, Choo JW. Mid-term follow up results of subtalar distraction arthrodesis using a double done-block for calcaneal malunion. Yonsei Med J, 2014, 55(4): 1087-1094.
8.	范伟力, 王子明, 赵玉峰, 等. 距下关节截骨缓慢延长治疗陈旧性跟骨骨折. 创伤外科杂志, 2011, 13(3): 219-222.
9.	车晓凌. 手术治疗跟骨骨折 47 例分析. 实用骨科杂志, 2014, 20(12): 1145-1147.
10.	Myerson M, Quill GE Jr. Late complications of fractures of the calcaneus. J Bone Joint Surg (Am), 1993, 75(3): 331-341.
11.	Rammelt S, Grass R, Zawadski T, et al. Foot function after subtalar distraction bone-block arthrodesis. A prospective study. J Bone Joint Surg (Br), 2004, 86(5): 659-668.
12.	Chung HJ. Calcaneal Malunion. J Korean Foot Ankle Soc, 2012, 16(2): 79-86.
13.	Gallie WE. Subastragalar arthrodesis in fractures of the os calcis. J Bone Joint Surg, 1943, 25(4): 731-736.
14.	Carr JB, Hansen ST, Benirschke SK. Subtalar distraction bone block fusion for late complications of os calcis fractures. Foot Ankle, 1988, 9(2): 81-86.
15.	武勇, 王岩, 王金辉, 等. 距下关节撑开植骨融合治疗跟骨骨折畸形愈合. 中华外科杂志, 2010, 48(9): 655-657.
16.	Tuijthof GJ, Beimers L, Kerkhoffs GM, et al. Overview of subtalar arthrodesis techniques: options, pitfalls and solutions. Foot Ankle Surg, 2010, 16(3): 107-116.
17.	Bednarz PA, Beals TC, Manoli A 2nd. Subtalar distraction bone block fusion: an assessment of outcome. Foot Ankle Int, 1997, 18(12): 785-791.
18.	潘文杰, 雷文淼, 肖琳, 等. 经后外侧入路距下关节撑开植骨融合治疗陈旧性跟骨骨折畸形愈合. 中国骨与关节损伤杂志, 2014, 29(4): 366-368.
19.	Baravarian B. Block distraction arthrodesis for the treatment of failed calcaneal fractures. Clin Podiatr Med Surg, 2004, 21(2): 241-250.
20.	李毅, 赵宏谋, 梁晓军, 等. 改良小 L 形入路距下关节撑开植骨融合治疗陈旧性跟骨骨折距下关节炎. 中国骨伤, 2014, 27 (7): 536-539.
21.	李莹, 武勇, 王岩, 等. 距下关节撑开融合术治疗跟骨骨折畸形愈合 5 例临床观察. 山东医药, 2016, 56(4): 44-46.
22.	Laporta G, Bock F, Ghate N. Posterior approach for subtalar joint distraction arthrodesis by compact external fixation: a technique guide. J Foot Ankle Surg, 2013, 52(4): 547-552.
23.	Fellmann J, Zollinger H. Surgical fusion of the subtalar joint—changing concepts in changing times. Z Orthop Ihre Grenzgeb, 1996, 134(4): 341-345.
24.	Easley ME, Trnka HJ, Schon LC, et al. Isolated subtalar arthrodesis. J Bone Joint Surg (Am), 2000, 82(5): 613-624.
25.	Beimers L, de Leeuw PA, van Dijk CN. A 3-portal approach for arthroscopic subtalar arthrodesis. Knee Surg Sports Traumatol Arthrosc, 2009, 17(7): 830-834.
26.	Carro LP, Golanó P, Vega J. Arthroscopic subtalar arthrodesis: the posterior approach in the prone position. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 2007, 23(4): 441.e1-445.e4.
27.	Kalamchi A, Evans JG. Posterior subtalar fusion. A preliminary report on a modified Gallie’s procedure. J Bone Joint Surg (Br), 1977, 59(3): 287-289.
28.	Trnka HJ, Easley ME, Lam PW, et al. Subtalar distraction bone block arthrodesis. J Bone Joint Surg (Br), 2001, 83(6): 849-854.
29.	Chiang CC, Tzeng YH, Lin CF, et al. Subtalar distraction arthrodesis using fresh-frozen allogeneic femoral head augmented with local autograft. Foot Ankle Int, 2013, 34(4): 550-556.
30.	Lee MS, Tallerico V. Distraction arthrodesis of the subtalar joint using allogeneic bone graft: a review of 15 cases. J Foot Ankle Surg, 2010, 49(4): 369-374.
31.	Monaco SJ, Brandao RA, Manway JM, et al. Subtalar distraction arthrodesis with fresh frozen femoral neck allograft: A retrospective case series. Foot Ankle Spec, 2016, 9(5): 423-428.
32.	Garras DN, Santangelo JR, Wang DW, et al. Subtalar distraction arthrodesis using interpositional frozen structural allograft. Foot Ankle Int, 2008, 29(6): 561-567.
33.	Henning C, Poglia G, Leie MA, et al. Comparative study of subtalar arthrodesis after calcaneal frature malunion with autologous bone graft or freeze-dried xenograft. Journal of Experimental Orthopaedics, 2015, 2(1): 1-9.
34.	Zion I, Shabat S, Marin L, et al. Subtalar distraction arthrodesis using a ramp cage. Orthopedics, 2003, 26(11): 1117-1119.
35.	Papadelis EA, Karampinas PK, Kavroudakis E, et al. Isolated subtalar distraction arthrodesis using porous tantalum: A pilot study. Foot Ankle Int, 2015, 36(9): 1084-1088.
36.	Palmanovich E, Brin YS, Ben David D, et al. Use of a spinal cage for creating stable constructs in ankle and subtalar fusion. J Foot Ankle Surg, 2015, 54(2): 254-257.
37.	Myerson MS, Neufeld SK, Uribe J. Fresh-frozen structural allografts in the foot and ankle. J Bone Joint Surg (Am), 2005, 87(1): 113-120.
38.	Chan SC, Alexander IJ. Subtalar arthrodesis with interposition tricortical iliac crest graft for late pain and deformity after calcaneus fracture. Foot Ankle Int, 1997, 18(10): 613-615.
39.	Chung HJ, Yum JK, Chung KJ, et al. Subtalar distraction arthrodesis for calcaneal malunion. J Korean Fract Soc, 2006, 19(1): 34-40.
40.	Pollard JD, Schuberth JM. Posterior bone block distraction arthrodesis of the subtalar Joint: a review of 22 cases. J Foot Ankle Surg, 2008, 47(3): 191-198.
41.	Shibuya N, Smith RS, Escobedo LA, et al. A push-pull distraction method for arthroscopic subtalar joint arthrodesis. J Foot Ankle Surg, 2014, 53(6): 825-828.
42.	Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
43.	Chandler JT, Bonar SK, Anderson RB, et al. Results of in situ subtalar arthrodesis for late sequelae of calcaneus fractures. Foot Ankle Int, 1999, 20(1): 18-24.
44.	Burton DC, Olney BW, Horton GA. Late results of subtalar distraction fusion. Foot Ankle Int, 1998, 19(4): 197-202.

1. Jackson JB 3rd, Jacobson L, Banerjee R, et al. Distraction subtalar arthrodesis. Foot Ankle Clin, 2015, 20(2): 335-351.
2. Schepers T. The subtalar distraction bone block arthrodesis following the late complications of calcaneal fractures: A systematic review. Foot (Edinb), 2013, 23(1): 39-44.
3. 周孝辉, 任玉清. 跟骨截骨矫形距下关节植骨融合术治疗严重跟骨骨折畸形愈合的手术方法及临床疗效. 世界最新医学信息文摘(电子版), 2016, (14): 92-93.
4. 李东风, 李先启, 燕志远, 等. 距下关节牵开植骨融合术治疗跟骨骨折畸形愈合的效果. 中国继续医学教育, 2015, 7(31): 113-115.
5. Clare MP, Lee WE 3rd, Sanders RW. Intermediate to long-term results of a treatment protocol for calcaneal fracture malunions. J Bone Joint Surg, 2005, 87(5): 963-973.
6. Amendola A, Lammens P. Subtalar arthrodesis using interposition iliac crest bone graft after calcaneal fracture. Foot Ankle Int, 1996, 17(10): 608-614.
7. Chung HJ, Bae SY, Choo JW. Mid-term follow up results of subtalar distraction arthrodesis using a double done-block for calcaneal malunion. Yonsei Med J, 2014, 55(4): 1087-1094.
8. 范伟力, 王子明, 赵玉峰, 等. 距下关节截骨缓慢延长治疗陈旧性跟骨骨折. 创伤外科杂志, 2011, 13(3): 219-222.
9. 车晓凌. 手术治疗跟骨骨折 47 例分析. 实用骨科杂志, 2014, 20(12): 1145-1147.
10. Myerson M, Quill GE Jr. Late complications of fractures of the calcaneus. J Bone Joint Surg (Am), 1993, 75(3): 331-341.
11. Rammelt S, Grass R, Zawadski T, et al. Foot function after subtalar distraction bone-block arthrodesis. A prospective study. J Bone Joint Surg (Br), 2004, 86(5): 659-668.
12. Chung HJ. Calcaneal Malunion. J Korean Foot Ankle Soc, 2012, 16(2): 79-86.
13. Gallie WE. Subastragalar arthrodesis in fractures of the os calcis. J Bone Joint Surg, 1943, 25(4): 731-736.
14. Carr JB, Hansen ST, Benirschke SK. Subtalar distraction bone block fusion for late complications of os calcis fractures. Foot Ankle, 1988, 9(2): 81-86.
15. 武勇, 王岩, 王金辉, 等. 距下关节撑开植骨融合治疗跟骨骨折畸形愈合. 中华外科杂志, 2010, 48(9): 655-657.
16. Tuijthof GJ, Beimers L, Kerkhoffs GM, et al. Overview of subtalar arthrodesis techniques: options, pitfalls and solutions. Foot Ankle Surg, 2010, 16(3): 107-116.
17. Bednarz PA, Beals TC, Manoli A 2nd. Subtalar distraction bone block fusion: an assessment of outcome. Foot Ankle Int, 1997, 18(12): 785-791.
18. 潘文杰, 雷文淼, 肖琳, 等. 经后外侧入路距下关节撑开植骨融合治疗陈旧性跟骨骨折畸形愈合. 中国骨与关节损伤杂志, 2014, 29(4): 366-368.
19. Baravarian B. Block distraction arthrodesis for the treatment of failed calcaneal fractures. Clin Podiatr Med Surg, 2004, 21(2): 241-250.
20. 李毅, 赵宏谋, 梁晓军, 等. 改良小 L 形入路距下关节撑开植骨融合治疗陈旧性跟骨骨折距下关节炎. 中国骨伤, 2014, 27 (7): 536-539.
21. 李莹, 武勇, 王岩, 等. 距下关节撑开融合术治疗跟骨骨折畸形愈合 5 例临床观察. 山东医药, 2016, 56(4): 44-46.
22. Laporta G, Bock F, Ghate N. Posterior approach for subtalar joint distraction arthrodesis by compact external fixation: a technique guide. J Foot Ankle Surg, 2013, 52(4): 547-552.
23. Fellmann J, Zollinger H. Surgical fusion of the subtalar joint—changing concepts in changing times. Z Orthop Ihre Grenzgeb, 1996, 134(4): 341-345.
24. Easley ME, Trnka HJ, Schon LC, et al. Isolated subtalar arthrodesis. J Bone Joint Surg (Am), 2000, 82(5): 613-624.
25. Beimers L, de Leeuw PA, van Dijk CN. A 3-portal approach for arthroscopic subtalar arthrodesis. Knee Surg Sports Traumatol Arthrosc, 2009, 17(7): 830-834.
26. Carro LP, Golanó P, Vega J. Arthroscopic subtalar arthrodesis: the posterior approach in the prone position. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 2007, 23(4): 441.e1-445.e4.
27. Kalamchi A, Evans JG. Posterior subtalar fusion. A preliminary report on a modified Gallie’s procedure. J Bone Joint Surg (Br), 1977, 59(3): 287-289.
28. Trnka HJ, Easley ME, Lam PW, et al. Subtalar distraction bone block arthrodesis. J Bone Joint Surg (Br), 2001, 83(6): 849-854.
29. Chiang CC, Tzeng YH, Lin CF, et al. Subtalar distraction arthrodesis using fresh-frozen allogeneic femoral head augmented with local autograft. Foot Ankle Int, 2013, 34(4): 550-556.
30. Lee MS, Tallerico V. Distraction arthrodesis of the subtalar joint using allogeneic bone graft: a review of 15 cases. J Foot Ankle Surg, 2010, 49(4): 369-374.
31. Monaco SJ, Brandao RA, Manway JM, et al. Subtalar distraction arthrodesis with fresh frozen femoral neck allograft: A retrospective case series. Foot Ankle Spec, 2016, 9(5): 423-428.
32. Garras DN, Santangelo JR, Wang DW, et al. Subtalar distraction arthrodesis using interpositional frozen structural allograft. Foot Ankle Int, 2008, 29(6): 561-567.
33. Henning C, Poglia G, Leie MA, et al. Comparative study of subtalar arthrodesis after calcaneal frature malunion with autologous bone graft or freeze-dried xenograft. Journal of Experimental Orthopaedics, 2015, 2(1): 1-9.
34. Zion I, Shabat S, Marin L, et al. Subtalar distraction arthrodesis using a ramp cage. Orthopedics, 2003, 26(11): 1117-1119.
35. Papadelis EA, Karampinas PK, Kavroudakis E, et al. Isolated subtalar distraction arthrodesis using porous tantalum: A pilot study. Foot Ankle Int, 2015, 36(9): 1084-1088.
36. Palmanovich E, Brin YS, Ben David D, et al. Use of a spinal cage for creating stable constructs in ankle and subtalar fusion. J Foot Ankle Surg, 2015, 54(2): 254-257.
37. Myerson MS, Neufeld SK, Uribe J. Fresh-frozen structural allografts in the foot and ankle. J Bone Joint Surg (Am), 2005, 87(1): 113-120.
38. Chan SC, Alexander IJ. Subtalar arthrodesis with interposition tricortical iliac crest graft for late pain and deformity after calcaneus fracture. Foot Ankle Int, 1997, 18(10): 613-615.
39. Chung HJ, Yum JK, Chung KJ, et al. Subtalar distraction arthrodesis for calcaneal malunion. J Korean Fract Soc, 2006, 19(1): 34-40.
40. Pollard JD, Schuberth JM. Posterior bone block distraction arthrodesis of the subtalar Joint: a review of 22 cases. J Foot Ankle Surg, 2008, 47(3): 191-198.
41. Shibuya N, Smith RS, Escobedo LA, et al. A push-pull distraction method for arthroscopic subtalar joint arthrodesis. J Foot Ankle Surg, 2014, 53(6): 825-828.
42. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
43. Chandler JT, Bonar SK, Anderson RB, et al. Results of in situ subtalar arthrodesis for late sequelae of calcaneus fractures. Foot Ankle Int, 1999, 20(1): 18-24.
44. Burton DC, Olney BW, Horton GA. Late results of subtalar distraction fusion. Foot Ankle Int, 1998, 19(4): 197-202.

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Application and research progress of subtalar distraction bone block arthrodesis in treatment of calcaneus fracture malunion

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