Primary subtalar arthrodesis for the treatment of comminuted fractures of the calcaneus.

Comminuted fractures of the calcaneus are extremely difficult to manage, and the prognosis after this type of injury is particularly poor. The author has approached this problem with precise and anatomic restoration of the height and width of the calcaneus with open reduction and internal fixation followed by primary subtalar arthrodesis. The surgical technique of primary arthrodesis is complex and is described in detail. The rate of arthrodesis and return of function is surprisingly good given the magnitude of comminution present and has given us renewed hope that these injuries should not be abandoned to later salvage attempts at reconstruction.