Non-operative
Walking cast / NSAIDS
- 6/52
UCBL
- 3/12
- worn inside the shoe
- ends under malleoli
- controls the heel (which must be flexible)
- supports the arch
Operative / Synovectomy and debridement
(+/- FDL transfer and calcaneal osteotomy +/- T Achilles lengthening)
Able to achieve relatively high level of function after STJ fusion
- previously believed that isolated STJ fusion should not be performed
- believed that triple arthrodesis was operation of choice for hindfoot
- STJ fusion has superior result with less stress on AJ
Average loss of DF 30% / PF 10%
Position of hindfoot determines flexibility of transverse tarsal (CCJ & TNJ) joints
- imperative that fusion be positioned in ~ 5o valgus