The subtalar joint complex consists of the posterior facet joint (primary) and the anterior/middle facet joints (secondary, separated by the sinus tarsi). Hindfoot inversion-eversion at the subtalar joint is the primary motion controlling the pronation-supination of the entire foot during gait. Subtalar arthritis from calcaneal fracture malunion, inflammatory arthritis, or primary osteoarthritis produces a rigid painful hindfoot.
Subtalar arthritis from calcaneal fracture sequelae (Sanders type III-IV fractures) produces a rigid valgus hindfoot with subtalar pain on uneven ground. Subtalar arthroscopy allows minimally invasive assessment and debridement. In-situ subtalar arthrodesis with two lag screws provides reliable pain relief with 90-95% fusion rates.
Subtalar joint degeneration from calcaneal fracture malunion producing rigid hindfoot pain managed with in-situ subtalar arthrodesis.
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