Isolated Subtalar Arthrodesis

An isolated subtalar arthrodesis through a sinus tarsi approach with cannulated screw fixation is safe, reproducible, and effective for specific hindfoot pathology in adults. Perform a comprehensive clinical and radiographic assessment. Position the patient supine on the operating table with a bump under the ipsilateral hip, to internally rotate the involved leg. Mark a longitudinal incision from just inferior to the tip of the lateral malleolus and extending toward the base of the 4th metatarsal. Expose the subtalar joint by reflecting the extensor digitorum brevis and protecting the peroneal tendons. Meticulously prepare the subtalar joint using osteotomes and curets down to healthy bleeding subchondral bone. Reduce the subtalar joint into 5° of valgus and fix it with cannulated screws. Meticulously close the wound in layers and place the lower leg in a well-padded plaster back slab with the ankle in a neutral position. The operatively treated leg is kept immobilized and non-weight-bearing for the first 6 weeks. Numerous retrospective articles have reported high fusion rates and good functional outcomes after isolated subtalar arthrodesis, for all indications.