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How many screws are necessary for subtalar fusion? A retrospective study.

Abstract

BACKGROUND

Biomechanical studies have shown a higher compressive force and higher torsional stiffness for fixation with three screws compared to two screws. However, clinical data to compare these fixation techniques is still lacking.

METHODS

A retrospective analysis of 113 patients was performed, who underwent isolated subtalar fusion between January 2006 and April 2018.

RESULTS

Revision arthrodesis was required in 8% (n=6/36) for 3-screw-fixation and 38% (n=35/77) for 2-screw-fixation. For 3-screw-fixation, non-union, was observed in 14% (n=5/36) compared to 35% (n=27/77) in 2-screw fixation. Non-union (p=.025) and revision arthrodesis (p=.034) were significantly more frequent in patients with 2 screws. A body mass index ≥30kg/m2 (p=.04, OR=2.6,95%CI:1.1-6.3), prior ankle-fusion (p=.017,OR=4.4,95%CI:1.3-14.5) and diabetes mellitus (p=.04,OR=4.9,95%CI:1.1-17.8) were associated with a higher rate of revision arthrodesis.

CONCLUSIONS

Our findings suggest that successful subtalar fusion is more reliably achieved with use of three screws. However, future prospective studies will be necessary to further specify this recommendation.

Authors+Show Affiliations

Department of Orthopedics, University Hospital Balgrist, Zürich, ZH, Switzerland.Department of Orthopedics, University Hospital Balgrist, Zürich, ZH, Switzerland.Department of Orthopedics, University Hospital Balgrist, Zürich, ZH, Switzerland.Department of Orthopedics, University Hospital Balgrist, Zürich, ZH, Switzerland.Department of Orthopedics, University Hospital Balgrist, Zürich, ZH, Switzerland.Department of Orthopedics, University Hospital Balgrist, Zürich, ZH, Switzerland. Electronic address: lukas.urbanschitz@balgrist.ch.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31522872

Citation

Wirth, Stephan H., et al. "How Many Screws Are Necessary for Subtalar Fusion? a Retrospective Study." Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons, 2019.
Wirth SH, Viehöfer A, Fritz Y, et al. How many screws are necessary for subtalar fusion? A retrospective study. Foot Ankle Surg. 2019.
Wirth, S. H., Viehöfer, A., Fritz, Y., Zimmermann, S. M., Rigling, D., & Urbanschitz, L. (2019). How many screws are necessary for subtalar fusion? A retrospective study. Foot and Ankle Surgery : Official Journal of the European Society of Foot and Ankle Surgeons, doi:10.1016/j.fas.2019.08.017.
Wirth SH, et al. How Many Screws Are Necessary for Subtalar Fusion? a Retrospective Study. Foot Ankle Surg. 2019 Sep 6; PubMed PMID: 31522872.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How many screws are necessary for subtalar fusion? A retrospective study. AU - Wirth,Stephan H, AU - Viehöfer,Arnd, AU - Fritz,Yannick, AU - Zimmermann,Stefan M, AU - Rigling,Dominic, AU - Urbanschitz,Lukas, Y1 - 2019/09/06/ PY - 2019/07/16/received PY - 2019/08/28/accepted PY - 2019/9/17/entrez KW - Arthrodesis KW - Fusion KW - Revision KW - Screws KW - Subtalar JF - Foot and ankle surgery : official journal of the European Society of Foot and Ankle Surgeons JO - Foot Ankle Surg N2 - BACKGROUND: Biomechanical studies have shown a higher compressive force and higher torsional stiffness for fixation with three screws compared to two screws. However, clinical data to compare these fixation techniques is still lacking. METHODS: A retrospective analysis of 113 patients was performed, who underwent isolated subtalar fusion between January 2006 and April 2018. RESULTS: Revision arthrodesis was required in 8% (n=6/36) for 3-screw-fixation and 38% (n=35/77) for 2-screw-fixation. For 3-screw-fixation, non-union, was observed in 14% (n=5/36) compared to 35% (n=27/77) in 2-screw fixation. Non-union (p=.025) and revision arthrodesis (p=.034) were significantly more frequent in patients with 2 screws. A body mass index ≥30kg/m2 (p=.04, OR=2.6,95%CI:1.1-6.3), prior ankle-fusion (p=.017,OR=4.4,95%CI:1.3-14.5) and diabetes mellitus (p=.04,OR=4.9,95%CI:1.1-17.8) were associated with a higher rate of revision arthrodesis. CONCLUSIONS: Our findings suggest that successful subtalar fusion is more reliably achieved with use of three screws. However, future prospective studies will be necessary to further specify this recommendation. SN - 1460-9584 UR - https://www.unboundmedicine.com/medline/citation/31522872/How_many_screws_are_necessary_for_subtalar_fusion_A_retrospective_study L2 - https://linkinghub.elsevier.com/retrieve/pii/S1268-7731(19)30149-3 DB - PRIME DP - Unbound Medicine ER -