Case Reports: Symptomatic Bilateral Talonavicular Coalition

Migues, Atilio; Slullitel, Gastón; Suárez, Esteban; Galan, Hernán

doi:10.1007/s11999-008-0500-4

Cited by 17 publications

(14 citation statements)

References 10 publications

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“…Talonavicular coalitions (as for the mother of our case) occur far less frequently than talocalcaneal and calcaneonavicular coalitions (Migues et al,2009). Stocker et al (2009) emphasized the possible etiology of tarsal coalition for CTEV that does not respond to the Ponseti method in the expected manner.…”

Section: Discussionmentioning

confidence: 48%

Foot anomalies and proximal symphalangism

et al. 2012

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A 2-week-old girl born at term (by vaginal delivery and without antenatal or perinatal events) was referred as having ''bilateral talipes and bilateral proximal symphalangism of little and ring fingers.'' The ''talipes'' was atypical with marked equinus and varus, but no cavus or adductus of the midfoot. Her mother had both symphalangism (absence of proximal interphalangeal joints) of middle, ring, and little fingers bilaterally and fixed pes planus with a rigid fixed hindfoot-and these deformities had also been present from birth. The maternal grandmother was similarly affected. However, the neonatal subject has an unaffected older sibling; maternal siblings are also unaffected. The three affected people did not have other obvious musculoskeletal abnormalities (elbow examination of the girl and her mother were normal and there were no peripheral stigmata of spinal anomalies). There was no history of musculoskeletal anomalies on the father's side. IMAGESRadiographs of the mother's left hand and foot are given in Figures 1 and 2, respectively. The radiographs of the mother's left foot (Fig. 2) show fusions of the middle and distal phalanges of the 3rd, 4th, and 5th toes. The distal aspect of the navicular is dome-shaped ( Fig. 2A).There are fusions of (i) the second metatarsal base to the intermediate cuneiform, (ii) the lateral cuneiform to the cuboid, and (iii) the talus with the navicular-these are best seen on the oblique view (Fig.2B). The lateral view (Fig. 2C) shows a planus (¼flat) deformity with no calcaneal pitch and absence of the lateral longitudinal arch.The pes planus causes the rays of the foot to be superimposed on the lateral view (Fig. 2C) which can cause confusion in the interpretation, e.g., a shadow at the base of the third metatarsal lies across the medial cuneiform, which makes its definition awkward.Tarsal and other foot coalitions thus co-exist with symphalangism in the mother.2. The deformity of the feet in the child was atypical for talipes given the lack of midfoot cavus and adductus. This reflects the likely underlying cause-as being due to a syndrome involving symphalangism and multiple foot coalitions. The feet of our patient were therefore treated with a modified Kite's method (as opposed to the Ponseti regime (Ponseti, 1996) which is dependent on the absence of coalitions) with serial casting and pressure under the calcaneo-

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Section: Discussionmentioning

confidence: 48%

Foot anomalies and proximal symphalangism

et al. 2012

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“…Frost and Fagan24 reported a case of simultaneous bilateral TN and CC (calcaneocuboid) coalitions. Migues et al 25 reported a case of symptomatic TN coalition with associated pedal anomalies. Bryson et al 26 described a case of symptomatic bilateral TN coalition with associated co-morbidities spanning two decades.…”

Section: Discussionmentioning

confidence: 99%

An incidental talonavicular coalition in a diabetic patient: a podiatric perspective

2014

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A tarsal coalition is a pathological union of two or more tarsal bones. The authors present an incidental finding of a unilateral talonavicular (TN) coalition that was overlooked in a 57-year-old diabetic female with signs and symptoms of peripheral neuropathy. This case highlights the clinical implications and important teaching points in recognising a TN coalition. This is particularly relevant for new, upcoming clinicians who may have never been exposed to this diagnostic rarity during clinical training.

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“…There is a strong genetic predisposition with talonavicular coalition inherited in an autosomal dominant pattern with high penetrance 4. It frequently occurs bilaterally and has been associated with a number of skeletal deformities including the great toe being shorter than the second, ball-and-socket ankle joint, carpal synostoses, peroneal spastic flat foot, symphalangisim and clinodactyly 5–8. Loss of the medial longitudinal arch places additional stress upon surrounding tendinous and soft-tissue structures and increases the load borne by adjacent bony articulations.…”

Section: Introductionmentioning

confidence: 99%