13 - Subtalar joint distraction arthrodesis utilizing titanium truss technology for posttraumatic calcaneal fracture arthritis

Abstract

Subtalar joint distraction arthrodesis has been recommended for the treatment of conditions such as nonunion or malunion of calcaneal fractures leading to post-traumatic arthritis. These conditions are difficult to treat, because the deformities created are complex. If these deformities are not corrected, ankle joint instability and wear will occur over time. In general, autograft or allograft wedges have been used to perform distraction arthrodesis of the subtalar joint. Although studies have shown success, there have been complications. Autografts have resulted in donor site morbidity and limitations on graft size. Allografts have shown high nonunion rates. Both have shown graft collapse over time. Recent literature has discussed the use of tantalum technology to span large defects in bone healing. Studies have shown that tantalum provides superior strength and bone incorporation compared with autografts and allografts. This chapter presents how truss technology can be used for distraction arthrodesis of the subtalar joint.