Complication and union rates of combined subtalar fusion and calcaneal osteotomy versus subtalar fusion alone in severe hindfoot deformity.

BACKGROUND: Subtalar arthrodesis (STA) is often used to correct arthritic hindfoot deformity, but calcaneal osteotomy (CO) may also be required. Few studies to date assess the outcomes of combined STA and CO compared to STA alone. This study aims to examine and compare union rates and complications between these groups.

METHODS: A retrospective review of patients aged 16 and older with stage 3-4 progressing collapsing foot deformity (PCFD) who underwent STA or STA and CO at the participating institutions was performed, with demographic matching between groups. Complications and radiographic union rates defined by greater than 50% osseus bridging on CT scans were compared using a two-tailed Fisher's exact test.

RESULTS: There were 21 patients in the STA and CO group, and 19 patients in our control group. There were no significant differences in complications between STA and the combined STA and CO group (p = 0.44). In both cohorts, only one case of delayed union was observed, with all other patients achieving union by the final follow up (p = 1.00).

CONCLUSION: This study supports that performing CO with a STA may be utilized to prevent under correction of hindfoot deformity without additional wound complication risk.

LEVEL OF EVIDENCE: Level III-Retrospective Comparative Study.