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PreOperative Planning for Subtalar Fusion



- See: Position of Subtalar Fusion

- Discussion:
    - knee deformities should be corrected prior to any forefoot fusions;
    - varus hindfoot may have compensatory forefoot valgus w/ plantarflexed 1st ray;
    - look for cavus type deformity
          - hammer toes may also be present;
          - observing pt's gait may reveal dynamic hammer toe formation in the cavus type of foot;
    - determine flexibility of forefoot & hindfoot;
          - if foot can be reduced to satisfactory position then subtalar fusion is enough;
          - if hindfoot deformity is fixed and cannot be brought into satisfactory position, a Triple Arthrodesis may be necessary;
    - valgus hindfoot may be associated w/ varus forefoot deformity along with an abducted forefoot via hindfoot joint;
          - look for Achilles tendon contracture w/ pronated deformity of the foot;
                 - accurate appraisal of contracted tendon may be difficult w/ fixed valgus deformity which prevents placement of hindfoot in varus;

- Radiographs:
    - Broden's view

- Case Example following Calcaneal Frx: