J Korean Fract Soc.  2019 Jul;32(3):121-127. 10.12671/jkfs.2019.32.3.121.

Computed Tomography Image Analysis of the Fusion Site of Subtalar Arthrodesis for Traumatic Arthritis after a Displaced Intraarticular Calcaneal Fracture

  • 1Department of Orthopaedic Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea. oselite@gilhospital.com


The study examined the fusion site and characteristics of the subtalar arthrodesis after intraarticular calcaneal fractures using computed tomography.
The clinical results and computed tomographic analysis of the fusion site were reviewed in 18 patients who were followed-up for a minimum of six months after undergoing subtalar arthrodesis due to traumatic arthritis caused by an intra-articular calcaneal fracture from December 2012 to April 2017.
An evaluation of clinical results after subtalar arthrodesis revealed statistically significant improvements. In all cases, arthritis was found in the injured articular surface, which was displaced superolaterally from the initial primary fracture line of the calcaneus. Six months after arthrodesis, the subtalar fusion rate was 80.0% (16/20). Of these, 14 cases had a cannulated screw inserted in the uninjured site that is medial to the primary fracture line. Joint fusion was observed on the uninjured articular surface in 17 cases (85.0%).
Joint fusion was initially achieved at the uninjured posterior facet after subtalar arthrodesis due to traumatic arthritis caused by a displaced intra-articular calcaneal fracture. This suggests that meticulous surgical techniques and cannulated screw positioning at the uninjured site will promote joint fusion.


Calcaneus; Fractures; Intra-articular; Subtalar joint; Arthritis; Computed tomography; Arthrodesis

MeSH Terms

Subtalar Joint


  • Fig. 1. Case of a 52-year-old male's radiologic image series undergoing subtalar arthrodesis. (A) The initial simple foot lateral X-ray shows an intraarticular calcaneal fracture. (B) The initial coronal view of the subtalar joint posterior facet in computed tomography (CT) image shows an intraarticular calcaneal fracture. The black line indicates the uninjured region and the white line indicates the injured region. (C) Simple lateral foot X-ray was performed after surgery. (D) The CT coronal view shows arthritic changes in the subtalar joint. (E) Simple lateral foot X-ray was performed after subtalar arthrodesis. The CT sagittal view shows partial union of the subtalar joint after subtalar arthrodesis (F), CT coronal view shows partial union of the subtalar joint after subtalar arthrodesis (G).

  • Fig. 2. The fusion ratio was calculated by dividing the total sum of fused segment length, shown as the short dashed arrow, by the total sum of posterior subtalar joint length, shown as the long solid arrow.



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