Subtalar Arthroscopy for Persistent Subfibular Pain After Calcaneal Fractures

Abstract

This is a report of 10 consecutive patients who had subtalar arthroscopy for persistent pain in the subfibular area after open reduction and internal fixation for intraarticular calcaneal fractures. The average period between the injury and the subtalar arthroscopy was 14.3 months (range, 6–36 months). The average follow-up period after subtalar arthroscopy for the patients who did not require further treatment was 16.7 months (average, 11–35 months). All the patients except two had chondromalacia. Three had grade II, three had grade III, and two had grade IV. Five patients had intra-articular adhesion. Two patients had a loose body. The power shaver has been used for debridement of the damaged cartilage and excision of the adhesion. Eight patients (80%) had considerable pain relief and did not require further local injection or surgical management. The two patients who required subtalar fusion had grade IV chondromalacic lesions. Only four patients had improvement in the range of motion of the subtalar joint. The preoperative American Orthopaedic Foot and Ankle Society Ankle-Hindfoot Score for the whole group was 69.9 points (range, 68–74 points), which was improved postoperatively to 77.2 points (range, 48–90 points). Subtalar arthroscopy for persistent pain after calcaneal fractures should be considered, especially if the radiological examination shows mild degenerative changes in the subtalar joint.