Talocalcaneal Joint Middle Facet Coalition Resection With Interposition of a Juvenile Hyaline Cartilage Graft

Tower, Dyane E.; Wood, Ryan; Vaardahl, Michael D.

doi:10.1053/j.jfas.2015.02.016

Cited by 10 publications

(9 citation statements)

References 28 publications

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“…In fact, a systematic review by Zengerink et al found 45% and 53% study weighted success rates in patients undergoing nonoperative treatment with rest or casting, respectively. 38 More specifically, there is a paucity of literature assessing the case scenarios, 10 prognostic factors, 11,22 and management protocols 36,38 that should be considered for the conservative treatment of OLT. Several studies have suggested that conservative treatment be reserved for patients with asymptomatic or incidental lesions, skeletally immature patients, and/or those with low-grade Berndt and Harty Lesions.…”

Section: Introductionmentioning

confidence: 99%

Conservative Management and Biological Treatment Strategies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

et al. 2018

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Section: Introductionmentioning

confidence: 99%

Conservative Management and Biological Treatment Strategies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

et al. 2018

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“…14,21,32 Otherwise, the insertion of interposition materials was frequently recommended by several authors to minimize the risk of TC relapse. 22,27,28,33 However, the optimum operative treatment has not yet been defined. Various tissues (fat grafts, 3,21,27,30,32 a PFF of subcutaneous fat tissue, 22 or a split of the FHLT 14,17,28 ) have been used as interposition materials in the past.…”

Section: Discussionmentioning

confidence: 99%

“…Further interposition materials, such as particulate juvenile hyaline cartilaginous allografts (JHCA) 33 or silicone sheets (SS), 16 were alternatively used after TC resection. The use of JHCA involves the risk of postoperative partial or fully delamination, host rejection, or infectious disease transmission, whereby interposition materials such as heterologous, nonabsorbable silicone sheets include the risk of bacteriological colonization and postoperative infection.…”

Section: Discussionmentioning

confidence: 99%

“…8,29 The talocalcaneal coalition (TC) results from a failure of embryonic mesenchymal differentiation/segmentation during development of the foot, 10,34 frequently involving both sides in up to 50% to 80% of the affected patients. 1,11 TC typically becomes symptomatic in preadolescence, 1,4,29 causing symptoms such as activity-related hindfoot pain, 20,33 stiffness of the subtalar joint, 23 or rigid pes planovalgus. 18,20 If conservative therapy fails to reduce symptoms adequately, operative treatment may be indicated to relieve pain, to increase the range of motion of the subtalar joint, and to prevent future osteoarthritis.…”

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confidence: 99%

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Resection of Medial Talocalcaneal Coalition With Interposition of a Pediculated Flap of Tibialis Posterior Tendon Sheath

et al. 2018

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“…• Other material with which we have no experience can also be used for interposition 7 . Interposition of a piece of fat to prevent recurrence.…”

Section: Excision Of a Middle Facet Tarsal Coalitionmentioning

confidence: 99%

Excision of a Middle Facet Tarsal Coalition

Li¹,

Myerson²

2020

JBJS Essential Surgical Techniques

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Background: Middle facet tarsal coalition is one of the commonly seen tarsal coalitions in clinical practice that can cause pain and associated flatfoot deformity. Excision of the coalition is one of the treatment options for symptomatic cases. Although symptoms may subside in children following a period of immobilization, resection should be considered as a treatment alternative for children and adolescents because of the potential for restoration of subtalar joint movement. The indications for excision of the coalition are not consistently reported in the literature, and the procedure is not always easy to perform. In this article, we describe the steps for a successful excision of a middle facet tarsal coalition. Description: The incision is marked from 1 cm inferior to the medial malleolus, extending distally to the navicular tuberosity and inferior to the level of the posterior tibial tendon. The coalition is first located by retracting the flexor tendons and the neurovascular bundle. The bone on the surface of the coalition is gradually removed to expose the middle facet. A 2-mm guide pin and a cannulated dilator probe inserted through the sinus tarsi into the tarsal canal that exits anterior to the posterior facet help with identifying the margins of the coalition. The middle facet is then removed either partially or totally, depending on the size, shape, and location of the coalition, until the posterior facet is visualized. Following excision, bone wax is used on the exposed surfaces or fat is inserted to prevent adhesion and recurrent bone formation. If there is an associated flatfoot deformity, additional surgeries, including a medial translational osteotomy or a lateral column lengthening of the calcaneus, a Cotton osteotomy, an arthroereisis, or a calcaneus stop procedure, may be necessary. Alternatives: The alternative treatment for managing a middle facet coalition is immobilization of the foot in a boot or cast for 6 to 8 weeks to decrease pain. This will not improve the function of the hindfoot, which remains stiff, but may alleviate pain temporarily. Excision of the coalition in combination with other procedures for correction of the flatfoot is an alternative to an arthrodesis of the subtalar joint and works well in children and adolescents, particularly in those with reasonable subtalar joint flexibility. A triple arthrodesis is rarely Disclosure: The authors indicated that no external funding was received for any aspect of this work. The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSEST/A285).

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Talocalcaneal Joint Middle Facet Coalition Resection With Interposition of a Juvenile Hyaline Cartilage Graft

Cited by 10 publications

References 28 publications

Conservative Management and Biological Treatment Strategies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Conservative Management and Biological Treatment Strategies: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle

Resection of Medial Talocalcaneal Coalition With Interposition of a Pediculated Flap of Tibialis Posterior Tendon Sheath

Excision of a Middle Facet Tarsal Coalition

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