[Reconstruction of calcaneal thalamus by bone autograft and subtalar arthrodesis for antiquated intra-articular calcaneal fractures].

Objective To introduce a clinical treatment for the reconstruction of calcaneal thalamus by bone autograft and subtalar arthrodesis for antiquated intra-articular calcaneal fractures. Methods From July 2000 to October 2003, 11 cases with antiquated intra-articular calcaneal fractures were treated. Of the 11 cases, 9 were males and 2 females,whose ages ranged from 21 to 48 years. All unilateral calcanei were involved in the 11 cases. The modified extended L-shaped approach lateral to calcaneus was adopted. The primary treatment was manipulation and immobilization with the reconstruction of calcaneal thalamus by bone autograft and subtalar arthrodesis. The average volume of the ilium for the autograft was 3.0 cm×2.5 cm×1.8 cm. Protruded osteophyte from the lateral wall of calcaneus were ablated in all 11 cases. Results All the 11 cases were followed up for 3 to 18 months, 11.5 months on average. The reconstructed calcaneal thalamus was healed 10 to 12 weeks after the operation. Some of the patients could walk with load 8 weeks after the operation, and the average time for all the patients to walk with load was 13.2 weeks. There were 4 cases of excellent result, 5 cases of good result, and 2 cases of fair result, according to ZHANG Tieliang's foot score system. Plain radiograph showed that B[AKo¨]hler angle, width of calcaneus and height of calcaneal thalamus were nearly restored to normal. Conclusion With the improvement of calcaneal abnormality and restoration of the shape and function of hind foot, reconstruction of calcaneal thalamus by bone autograft combined with subtalar arthrodesis is effective in treating antiquated intra-articular calcaneal fractures.