Talocalcaneal middle facet coalitions are associated with rigid pes planovalgus that
often requires surgical intervention. Simple resection of the coalition is preferred
for symptomatic cases in the absence of rearfoot arthritis. While resection of the
coalition will remove the osseous restriction of motion and may eliminate pain, the
procedure does not specifically correct the concomitant pes planovalgus. In this report
of 6 feet in 3 patients, we advocate combining resection of the coalition with concomitant
flatfoot reconstruction in a single-stage operation. The patients in this series averaged
13.67 (range 12–17) years of age at the time of their foot surgeries, and their follow-up
averaged 30 (range 16–54) months. All of the patients displayed bilateral middle facet
talocalcaneal coalitions and underwent bilateral resection combined with flatfoot
reconstruction. Each patient had 1 foot corrected followed by a period of at least
6 months before the contralateral foot was corrected. The mean postoperative American
Orthopaedic Foot and Ankle Society ankle-hindfoot score was excellent (94.33 ± 2.81
points) overall. The median radiographic values for calcaneal inclination, Meary's,
and anteroposterior talar-first metatarsal angles demonstrated statistically significant
improvements: 9° (3°, 13°) (P = .0273), 4° (2°, 7°) (P = .0269), and 6° (3°, 11°) (P = .0277), respectively, and all feet demonstrated improved subtalar joint motion
without pain. Although long-term results remain to be determined in a larger cohort,
it is hoped that this combined approach to talocalcaneal coalition will delay or obviate
future rearfoot arthrosis and the need for arthrodesis. Level of Clinical Evidence:
4.
Key words
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Article info
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Conflict of Interest: None reported.
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© 2008 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.
