Endoscopic Resection of a Talocalcaneal Coalition Using a Posteromedial Approach

Hayashi, Kôji; Kumai, Tsukasa; Tanaka, Yasuhito

doi:10.1016/j.eats.2013.08.005

Cited by 7 publications

(4 citation statements)

References 9 publications

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“…Contrary to the literature that suggests the de facto approach to resection usually follows a trial of conservative management [8], the majority of patients in our cohort did not have a trial of conservative management prior to the resection of the coalition. In general, there was minimal benefit for patients that underwent a trial of conservative management when compared with patients who did not.…”

Section: Prior Conservative Management and Additional Operative Inter...contrasting

confidence: 85%

“…It did not seem the case that a trial of conservative treatment in surgically managed coalitions led to a substantial improvement in AOFAS scores when compared with surgical resection alone. This is interesting as it suggests that the mainstay of management, a trial of conservative treatment before resection, may not influence the overall outcome for the patient [ 8 ]. However, the benefits of conservative intervention may not be immediately clear from this study.…”

Section: Reviewmentioning

confidence: 99%

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Talocalcaneal Coalition Resection in the Adult Population: A Systematic Review

Dermanis¹,

Elmajee²,

Duffaydar³

et al. 2022

Cureus

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Tarsal coalition is a congenital malformation of the tarsal bones of the foot that typically presents with features such as pain, recurrent sprains, and flat foot in childhood. In a small number of patients, a delayed presentation may be apparent, with symptoms instead presenting in adulthood. The most commonly accepted hypothesis is that the tarsal coalition becomes more symptomatic as the coalition progressively ossifies. To this date, no author has systematically evaluated the literature to identify the best approach when surgically managing these patients, in particular concerning the resection of the coalition. This study aims to systematically review the literature, searching EMBASE, MEDLINE, Web of Science, Google Scholar, and the Cochrane Library to identify and evaluate studies that presented an outcome for resection of the adult talocalcaneal coalition. Alongside overall outcomes, details on the extent of the coalition, surgical method, post-operative regimen, and presenting symptoms were extracted for each patient studied. This was conducted in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. With 72 patients, this is the largest evaluation of an adult tarsal coalition population to date. Our findings indicate that talocalcaneal coalition in adulthood presents differently from the classical peroneal spasm found in childhood. Better scores were reported for coalitions either managed with an endoscopic approach or with interposition of the flexor hallucis longus tendon. Despite some reported benefits in the literature, a trial of conservative management or the use of a rehabilitation regimen had a limited impact on the overall patient outcome. Tarsal coalition in adulthood requires rigorous clinical evaluation to identify appropriate management options. Resection of the coalition is a safe approach to definitively managing these patients, but consideration should be given to the surgical method to ensure each patient has the best outcomes. In particular, consideration should be given to using an endoscopic approach or interposition of the flexor hallucis longus tendon in order to achieve the best patient outcomes. However, there remains a paucity of literature evaluating this demographic and further high-impact studies are required to comprehensively evaluate this population.

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Section: Prior Conservative Management and Additional Operative Inter...contrasting

confidence: 85%

Section: Reviewmentioning

confidence: 99%

Talocalcaneal Coalition Resection in the Adult Population: A Systematic Review

Dermanis¹,

Elmajee²,

Duffaydar³

et al. 2022

Cureus

View full text Add to dashboard Cite

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“…The surgical technique was similar to Bonasia et al 3 and Hayashi et al 8 in utilizing prone positioning and 2 working peri-Achilles tendon portals. The FHL and neurovascular bundle were protected medial to the burr using a retractor (Figure 2C), although the distraction was not needed in the surgery.…”

Section: Surgical Techniquementioning

confidence: 99%

“…Moreover, the posterior subtalar articular facet can be fully exposed, and the extent of excision can be evaluated by arthroscopy. Hayashi et al 8 reported a surgical technique of resecting the middle and posterior articular facets using a posteromedial approach. They found that arthroscopy allowed a sufficient working space and could be a direct approach to the middle and posterior articular facets without obstruction.…”

Section: Introductionmentioning

confidence: 99%

Midterm Outcomes of Talocalcaneal Coalition Arthroscopic Resection in Adults

Wang

Chen

et al. 2022

Foot Ankle Int.

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Background: Arthroscopic resection of the talocalcaneal coalition (TCC) has been reported to be associated with good short-term outcomes. However, the midterm outcomes of this approach remain uncertain. Methods: We performed a retrospective study of patients who underwent arthroscopic resection for symptomatic TCC. The patients were divided into 2 groups (group P, patients with isolated posterior facet coalition; and group MP, patients with both middle and posterior facet coalition). The preoperative and postoperative visual analog scale (VAS) scores for pain and American Orthopaedic Foot & Ankle Society (AOFAS) scale scores were calculated. The postoperative AOFAS and VAS scores between the 2 groups were analyzed. Patient satisfaction was also assessed. Results: Thirty-two patients were included in this study. The mean age at the time of surgery was 26.0±8.5 years, and the mean follow-up period was 56.9±18.0 months. Thirteen (41%) patients were in group P, whereas 19 (59%) patients were in group MP. Postoperative VAS and AOFAS scores improved more significantly than preoperative scores. At the final follow-up, excellent and good subjective outcomes were attained in 26 patients (81%), fair and poor outcomes in 6 patients (19%). There were no statistical differences in the postoperative AOFAS (91.0±7.0 vs 85.8±10.8, P = .532) and VAS score (2.1±1.7 vs 4.0±2.6, P = .537) between patients with the ratio of coalition/posterior facet more than or less than 50%. There were no statistical differences in postoperative VAS score (1.8±1.3 vs 2.6±2.2, P = .236) and AOFAS score (92.5±5.6 vs 89.2±8.7, P = .297) between group P (n=13) and group MP (n=19), either. Three patients (9.4%) had complications, including these notable findings: 1 patient complained of restricted dorsal flexion, 1 with computed tomography–proven coalition recurrence, and 1 with partial tibial nerve injury. Conclusion: We found that TCC arthroscopic resection was generally associated with reasonable outcomes at midterm follow-up. Level of Evidence: Level IV, case series.

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