Is Distraction Bone Block Arthrodesis better than Subtalar Arthrodesis for Malunited Calcaneal Fractures with Subtalar Arthritis? A Retrospective Case Series

To compare the clinicoradiological outcome between in situ and distraction bone block arthrodesis in patients with malunited calcaneal fracture. Materials and methods: Patients presenting with painful subtalar joint arthritis between January 2015 and March 2018 were included after thorough clinical and radiological evaluation. In situ group I had 22 patients and distraction group II had 14. All patients were evaluated at final follow-up for functional outcome with American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, and radiological parameters including talocalcaneal height (TCH), calcaneal pitch (CP), lateral talocalcaneal angle (LTCA), and talar declination angle (TDA). Results: Mean follow-up was 19.26 months for in situ and 12.91 months for distraction group. AOFAS ankle-hindfoot score improved postoperative in both groups, but the difference between the groups was not significant (p value = 0.371). Statistically significant improvement was observed in radiological parameters of talocalcaneal height (p value = 0.006), calcaneal pitch (p value = 0.025), lateral talocalcaneal angle (p value = 0.078), and talar declination angle(p value = 0.02) in the distraction group. Conclusion: Distraction arthrodesis restores hindfoot radiological parameters better compared to the in situ group; however, there is no significant difference in functional outcome between the groups.