Objective: To review the operative technique of tre-phine arthrodesis of subtalar joints and evaluate its clinical effect.Methods: From June 1998 to October 2006, we per-formed subtalar arthrodesis on 38 feet of 34 patients for a variety of painful disorders of hindfoot with trephine technique. Clinical and radiologic follow-up evaluations were performed for 45 months on average (range, 21 to 110 months) after arthrodesis.Results: No severe complications were found in this study except one patient with dropfoot and two with skin necrosis. The average anlde-hindfoot scores of the American Orthopaedic Foot and Ankle Society (AOFAS) was improved from 48.3 preoperatively to 79.2 postoperatively (P<0.05). The pain scores of visual analogue scales (VAS) decreased from 7.2 (range, 3 to 10) preoperatively to 2.6 (range,1 to 6) post-operatively (P<0.05). Subjectively, the patients experienced improvements in pain, function, cosmesis, and shoewearing.Overall, 30 patients were satisfied and all patients would have this procedure again under similar circumstances. Post-operative radiology showed that complete union was found in 35 feet 6 months after operation, with the successful union rate of 92.1%. There was an increase in arthritic scores for 5 ankles, 4 talonavieular joints, 4 calcaneocuboid joints, and 4 midfoot joints. Nonunion occurred in 3 subtalar joints with anterolaterai approach, which required revision arthrodesis.Conclusion: Isolated subtalar arthrodesis with tre-phine method is an effective procedure for painful malalignment of hindfoot.