SURGICAL TREATMENT OF TALOCALCANEAL COALITION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

YU Guangrong , LI Chunguang , LI Bing , YANG Yunfeng , LIHaifeng , ZHOU Jiaqian , YUAN Feng.

Department of Orthopaedics, Tongji Hospitial, Tongji University, Shanghai, 200065, P.R.China.;

Corresponding author：

Keywords：

Talocalcaneal coal ition ,Simple resection, Arthrodesis

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Objective To explore the operative method and effectiveness of talocalcaneal coal ition.
Methods Between July 2008 and October 2010, 10 patients with talocalcaneal coal ition were treated, including 2 cases of
congenital talocalcaneal coal ition and 8 cases of secondary talocalcaneal coal ition. There were 4 males and 6 females, aged
53.5 years on average (range, 16-70 years). Three patients had middle-facet talocalcaneal coal ition and 7 had posterior-facet
talocalcaneal coal ition. The preoperative visual analogue score (VAS) was 9.0 ± 0.4. According to American Orthopedic
Foot and Ankle Society (AOFAS) hindfoot scale, the score was 42.4 ± 1.4. Two cases compl icated by subtalar degeneration.
Resection of the bone bar and fat packing were performed in 8 cases of simple talocalcaneal coal ition, and resection and subtalar
arthrodesis in 2 cases of talocalcaneal coal ition combined with subtalar degeneration. Results Primary healing of incisions
was obtained in all patients. Eight patients were followed up 18 months on average (range, 12-36 months). At last follow-up,
VAS was 2.0 ± 0.7, showing siginificant difference when compared with preoperative score (t=6.425, P=0.000). AOFAS score was
86.9 ± 2.3, showing significant difference when compared with preoperative score (t=7.634, P=0.000). The X-ray films showed
that no recurrence of talocalcaneal coal ition was observed in patients underdoing simple removal of bone bar, and bone fusion
was observed in patients undergoing arthrodesis. Conclusion To achieve satisfactory outcomes for talocalcaneal coal ition, a
reasonable surgical procedure should be chosen according to the specific facet and complication.

Citation： YU Guangrong,LI Chunguang,LI Bing,YANG Yunfeng,LIHaifeng,ZHOU Jiaqian,YUAN Feng.. SURGICAL TREATMENT OF TALOCALCANEAL COALITION. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(5): 522-526. doi: Copy

1.	Zaw H, Calder JD. Tarsal coalitions. Foot Ankle Clin, 2010, 15(2): 349-364.
2.	Huskisson EC. Measurement of pain. Lancet, 1974, 2(7789): 1127-1131.
3.	Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallax, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
4.	Root ML. Reappraisal of the negative impression cast and the subtalar joint neutral position revisited. J Am Podiatr Med Assoc, 1997, 87(4): 192-193.
5.	Fleming P, Rice JJ, Kelly I, et al. Resection of talocalcaneal coalition—the effect on subtalar joint movements. Foot and Ankle Surgery, 2004, 10(1): 13-16.
6.	Harris RI. Rigid valgus foot due to talocalcaneal bridge. J Bone Joint Surg (Am), 1955, 37-A(1): 169-183.
7.	Kulik SA Jr, Clanton TO. Tarsal coalition. Foot Ankle Int, 1996, 17(5): 286-296.
8.	Blitz NM. Pediatric & adolescent flatfoot reconstruction in combination with middle facet talocalcaneal coalition resection. Clin Podiatr Med Surg, 2010, 27(1): 119-133.
9.	Bonasia DE, Phisitkul P, Saltzman CL, et al. Arthroscopic resection of talocalcaneal coalitions. Arthroscopy, 2011, 27(3): 430-435.
10.	Field C, Ng A. Resection of middle facet coalition with arthroscopic guidance. J Foot Ankle Surg, 2009, 48(2): 273-276.
11.	Albert A, Deleu PA, Leemrijse T, et al. Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up. Orthop Traumatol Surg Res, 2011, 97(4): 401-405.
12.	Schenkel D, Degraauw J, Degraauw C. Talocalcaneal coalition in a 15 year old female basketball player. J Can Chiropr Assoc, 2010, 54(4): 222-228.
13.	Sperl M, Saraph V, Zwick EB, et al. Preliminary report: resection and interposition of a deepithelialized skin flap graft in tarsal coalition in children. J Pediatr Orthop B, 2010, 19(2): 171-176.
14.	Di Liddo PE, Rivard DS, Mehler AS, et al. Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: a case report. J Foot Ankle Surg, 2000, 39(5): 336-340.
15.	El Shazly O, Abou El Ela AA. Percutaneous resection of calcaneo-navicular coalition with interposition of synthetic graft. Foot (Edinb), 2011, 21(3): 138-141.

1. Zaw H, Calder JD. Tarsal coalitions. Foot Ankle Clin, 2010, 15(2): 349-364.
2. Huskisson EC. Measurement of pain. Lancet, 1974, 2(7789): 1127-1131.
3. Kitaoka HB, Alexander IJ, Adelaar RS, et al. Clinical rating systems for the ankle-hindfoot, midfoot, hallax, and lesser toes. Foot Ankle Int, 1994, 15(7): 349-353.
4. Root ML. Reappraisal of the negative impression cast and the subtalar joint neutral position revisited. J Am Podiatr Med Assoc, 1997, 87(4): 192-193.
5. Fleming P, Rice JJ, Kelly I, et al. Resection of talocalcaneal coalition—the effect on subtalar joint movements. Foot and Ankle Surgery, 2004, 10(1): 13-16.
6. Harris RI. Rigid valgus foot due to talocalcaneal bridge. J Bone Joint Surg (Am), 1955, 37-A(1): 169-183.
7. Kulik SA Jr, Clanton TO. Tarsal coalition. Foot Ankle Int, 1996, 17(5): 286-296.
8. Blitz NM. Pediatric & adolescent flatfoot reconstruction in combination with middle facet talocalcaneal coalition resection. Clin Podiatr Med Surg, 2010, 27(1): 119-133.
9. Bonasia DE, Phisitkul P, Saltzman CL, et al. Arthroscopic resection of talocalcaneal coalitions. Arthroscopy, 2011, 27(3): 430-435.
10. Field C, Ng A. Resection of middle facet coalition with arthroscopic guidance. J Foot Ankle Surg, 2009, 48(2): 273-276.
11. Albert A, Deleu PA, Leemrijse T, et al. Posterior arthroscopic subtalar arthrodesis: ten cases at one-year follow-up. Orthop Traumatol Surg Res, 2011, 97(4): 401-405.
12. Schenkel D, Degraauw J, Degraauw C. Talocalcaneal coalition in a 15 year old female basketball player. J Can Chiropr Assoc, 2010, 54(4): 222-228.
13. Sperl M, Saraph V, Zwick EB, et al. Preliminary report: resection and interposition of a deepithelialized skin flap graft in tarsal coalition in children. J Pediatr Orthop B, 2010, 19(2): 171-176.
14. Di Liddo PE, Rivard DS, Mehler AS, et al. Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: a case report. J Foot Ankle Surg, 2000, 39(5): 336-340.
15. El Shazly O, Abou El Ela AA. Percutaneous resection of calcaneo-navicular coalition with interposition of synthetic graft. Foot (Edinb), 2011, 21(3): 138-141.

Chinese Journal of Reparative and Reconstructive Surgery

SURGICAL TREATMENT OF TALOCALCANEAL COALITION

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