Block distraction arthrodesis for the treatment of failed calcaneal fractures.

We had excellent results with our procedure and had only one unsatisfied patient. This patient's fusion site had an undersized graft; therefore, he had continued pain. Because he had no further intra-articular pain, he did not feel the need for further surgery. Block distraction arthrodesis is far more difficult to perform than subtalar arthrodesis without the use of bone graft. It is critical to allow more intraoperative time during the first two or three cases than required for regular arthrodesis of the subtalar joint. It also is essential to place the heel in a rectus position at the time of arthrodesis. With proper preoperative examination and planning, meticulous intraoperative treatment, and guarded postoperative care, block distraction arthrodesis is an excellent procedure for the treatment of poorly-treated or neglected calcaneal fractures.