Subtalar arthrodesis with internal compression for post-traumatic arthritis

We studied retrospectively the results in 24 patients (25 feet) who had been treated by subtalar arthrodesis with internal compression for post-traumatic arthritis from 1988 to 1992. Fifteen patients were men (16 feet) and nine (9 feet) were women. Their mean age was 43 years (22 to 68), and the average duration of follow-up was four years (2 to 6). A single compression screw was used in all feet and iliac-crest bone grafting in ten. Union was achieved in 24 of the 25 feet (96%). Based on a clinical scale the results were excellent in 10 feet, good in 7, fair in 6, and poor in 2 and on the Angus and Cowell score they were good in 19 feet, fair in 4, and poor in 2. The two poor results were due to nonunion in one patient and reflex sympathetic dystrophy in the other. One reoperation was performed for nonunion. Eighteen patients (18 feet) were satisfied with the results, four were satisfied with reservations, and three were dissatisfied. Progressive ankle and midfoot arthritis did not occur in the absence of pre-existing degenerative changes in these joints. We conclude that isolated subtalar arthrodesis with internal compression was effective treatment for posttraumatic subtalar arthritis. Iliac-crest bone grafting was not routinely required.