Subtalar osteoarthritis in a patient with multiplanar deformity of the leg

Subtalar Pathology

Description of patient (type of occupation, indication of age, intensity of sport):

A 58 year old male patient sustained a calcaneal fracture, which was treated conservatively for patient's general conditions. Simultaneously he sustenained multiple fractures of the tibia which was treated with an external fixator.

History and previous treatment:

Calcanear and tibial multiple fractures

Current complaints:

Foot pain and leg deformity

Physical examination:

Pain at palpation of the subtalar joint


[Picture 1, 2, 3 + 4]

Additional investigation (CT/MRI):


Case summary:

Subtalar osteoarthiritis in a patient with multiplanar deformities of the leg

Question(s) to this case:

Should I perform a two steps procedure (tibial osteotomy and subtalar fusion) or a one step procedure (tibial osteotomy + subtalar fusion)


I would first do the tibial osteotomy.
It might well be that after the osteotomy the pain in the sbtalar joint resolves.
If not then do subtalar fusion as a second procedure