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3Definitive care


If the posterior facet is badly damaged, primary subtalar fusion is often the best form of treatment. Locking plates may also be used for added stability. Plate fixation across the hindfoot to the midfoot must be performed once the hindfoot-to-midfoot relationship has been restored to normal. One must avoid hindfoot varus, and medial, or lateral, column shortening.
These images show a primary subtalar fusion carried out as a part of treatment of this massive talar and calcaneal injury.