Abstract
Talocalcaneal tarsal coalitions are a common source of foot pain, stiffness, and deformity.
These coalitions are treated symptomatically with rest and periods of immobilization.
When those measures fail, surgical resection is attempted. This procedure is an anatomic
challenge with the consequence of leaving residual coalition. The residual coalition
primarily results from difficulty with intraoperative imaging because fluoroscopy
does not provide adequate detail of this area. Some investigators have recommended
intraoperative computed tomography after resection with reasonable results. We describe
the combination of an intraoperative computed tomography with a navigated instrument
system for resection of talocalcaneal coalitions. The use of a navigated probe and
burr aids in defining the most anterior, posterior, and medial extents of the coalition.
This technique reduces the morbidity, with less bone removed and preservation of intact
subtalar articulations and allows for an efficient, thorough, and controlled resection.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to The Journal of Foot and Ankle SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Rigid painful flatfoot secondary to tarsal coalition.Clin Orthop Relat Res. 1983; 177: 54-60
- The relative incidence of tarsal coalition.Clin Orthop Relat Res. 1983; 181: 28-36
- MRI of tarsal coalition: frequency, distribution, and innovative signs.Bull NYU Hosp Jt Dis. 2008; 66: 14-21
- Isolated subtalar arthrodesis.Foot Ankle Int. 1998; 19: 511-519
- Subtalar fusion for isolated subtalar disorders: preliminary report.Clin Orthop Relat Res. 1988; 226: 260-265
- Tarsal coalitions and peroneal spastic flat foot: a review.J Bone Joint Surg Am. 1984; 66: 976-984
- Retrospect—peroneal spastic flat foot (rigid valgus foot).J Bone Joint Surg Am. 1965; 47: 1657-1667
- Symptomatic talocalcaneal coalition: its clinical significance and treatment.Clin Orthop Relat Res. 1991; 269: 249-256
- Excision of symptomatic coalition of the middle facet of the talocalcaneal joint.J Bone Joint Surg Am. 1987; 69: 539-544
- Talocalcaneal coalition resection: a 10-year follow-up.J Pediatr Orthop. 1997; 17: 13-15
- Resection for symptomatic talocalcaneal coalition.J Pediatr Orthop. 1998; 18: 283-288
- Gait abnormalities following resection of talocalcaneal coalition.J Bone Joint Surg Am. 1997; 79: 369-374
- Resection for symptomatic talocalcaneal coalition.J Bone Joint Surg Br. 1994; 76: 797-801
- Interposition of the split flexor hallucis longus tendon after resection of a coalition of the middle facet of the talocalcaneal joint.J Bone Joint Surg Am. 1999; 81: 11-19
- Osseous and non-osseous coalition of the middle facet of the talocalcaneal joint.J Bone Joint Surg Am. 1992; 74: 529-535
- Surgical management of symptomatic talocalcaneal coalitions by resection of the sustentaculum tali.J Pediatr Orthop. 2003; 23: 493-497
- Reoperations after tarsal coalition resection: a population-based study.J Foot Ankle Surg. 2015; 54: 306-310
- Long-term functional outcomes of resected tarsal coalitions.Foot Ankle Int. 2013; 34: 1370-1375
- Etiology of peroneal spastic flat foot.J Bone Joint Surg Br. 1948; 30B: 624-634
- Computerized tomography of talocalcaneal tarsal coalition: a clinical and anatomic study.Foot Ankle. 1986; 6: 273-288
- Diagnosis of tarsal coalition with computed tomography.Clin Orthop Relat Res. 1986; 208: 282-288
- Evaluation of tarsal coalition by computed tomography.J Pediatr Orthop. 1984; 4: 365-369
- The use of a portable CT scanner for the intraoperative assessment of talocalcaneal coalition resections.J Pediatr Orthop. 2014; 34: 559-564
- Pediatric pedicle screw placement using intraoperative computed tomography and 3-dimensional image-guided navigation.Spine (Phila Pa 1976). 2012; 37: E188-E194
- Intra-operative computer navigation guided cervical pedicle screw insertion in thirty-three complex cervical spine deformities.J Craniovertebr Junction Spine. 2010; 1: 38-43
- A prospective comparison of computer-navigated and fluoroscopic-guided in situ fixation of slipped capital femoral epiphysis.J Pediatr Orthop. 2013; 33: 128-134
- Computer-assisted cannulated screw fixation for slipped capital femoral epiphysis.J Pediatr Orthop. 2005; 25: 167-170
- Zhonghua Yi Xue Za Zhi. 2014; 94: 1631-1634
- Switching to a pediatric dose O-arm protocol in spine surgery significantly reduced patient radiation exposure.J Pediatr Orthop. 2016; 36: 621-626
Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
