• Mario Herrera-Pérez, Cesar Andarcia-Bañuelos, Alexej Barg, Martin Wiewiorski, Victor Valderrabano, Ashley L Kapron, Josep Maria De Bergua-Domingo, and Jose Luis Pais-Brito.
• Orthopaedic Department, University Hospital of Canary Islands, La Laguna, Tenerife, Spain.
• Foot Ankle Int. 2015 Feb 1; 36 (2): 203-10.

BackgroundDifferent fixation techniques have been described in the literature for isolated subtalar arthrodesis (ISA). The purpose of this study was to compare the fusion rate and clinical outcome of ISA using cannulated compression screws or compression staples.MethodsThirty-three patients (33 feet) underwent ISA using screw (17 feet) or staples (16 feet) fixation. Patients were followed for 42.7 ± 16.4 months (range, 24.5-84.3 months). The subtalar fusion was assessed radiographically and clinically. Clinical outcome measures included the visual analog scale (VAS) for pain and American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score.ResultsThe average pain score decreased significantly from 6.4 ± 1.1 (range, 5-9) to 0.8 ± 1.3 (range, 0-4) (P < .001). In the screws group, the average AOFAS hindfoot score increased significantly from 54.6 ± 8.8 (range, 37-67) preoperatively to 86.1 ± 7.1 (range, 71-91) postoperatively (P < .001). In the staples group, the average AOFAS hindfoot score increased significantly from 53.4 ± 11.1 (range, 33-69) preoperatively to 83.4 ± 6.9 (range, 71-91) postoperatively (P < .001). The AOFAS hindfoot score was comparable in both groups (P = .149). Only the AOFAS hindfoot score function subgroup in the screw fixation was significantly higher than in the staples fixation group (P = .005). There were 4 cases of nonunion at the site of subtalar arthrodesis (2 from screws group, 2 from staples group). The complication rate was comparable in both groups.ConclusionThe fusion rate was comparable in both groups, while the postoperative functional outcome was significantly better in the screw fixation group.Level Of EvidenceLevel III, retrospective comparative cohort study.© The Author(s) 2014.

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