Subtalar distraction arthrodesis with autograft from simultaneous calcaneal wedge osteotomy: A novel technique

Gold standard treatment for a malunited collapsed calcaneal fracture is distraction subtalar joint arthrodesis with structural graft. Various grafts are have been reported in the literature with femoral head or iliac crest allograft being most common. The present case report demonstrates a case of a 64-year-old female who presented two years after attempted subtalar joint fusion. The patient had pain recalcitrant to conservative care with clear bony collapse on weight bearing radiography and complete non-union on computed tomography. A novel technique is presented wherein a dorsally based posterior calcaneal osteotomy is performed and the removed bone wedge placed into the subtalar fusion to serve as structural autograft. The patient remained non-weight-bearing for 8 weeks post-operatively. Computed tomography was obtained at 6 months after surgery noting greater than 40% osseous bridging. The patient had improvement in all symptomatology and had complete return to activity from her baseline before the index surgery. Technique is illustrated along with description of details.