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
Foot pain and leg deformity
Pain at palpation of the subtalar joint
[Picture 1, 2, 3 + 4]
Additional investigation (CT/MRI):
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