Talonavicular coalition. Objective gait analysis

Pontious, Jane; Hillstrom, H.; Monahan, Timothy J.; Connelly, Sean P.

doi:10.7547/87507315-83-7-379

Cited by 15 publications

(7 citation statements)

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“…Failure of differentiation and segmentation of the primitive mesenchyme was described as the etiology of talonavicular coalitions [1,3,6,9]. In our patient, a positive family history reveals the coalition to be familial.…”

Section: Discussionmentioning

confidence: 64%

Case Reports: Symptomatic Bilateral Talonavicular Coalition

Migues

Slullitel

Suárez

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Congenital talonavicular coalition is reported less frequently than talocalcaneal or calcaneonavicular coalition and represent approximately 1% of all tarsal coalitions. Although reportedly transmitted as an autosomal-dominant disorder, tarsal coalition may be inherited as an autosomal-recessive trait. It has been associated with various orthopaedic anomalies, including symphalangism, clinodactyly, a great toe shorter than the second toe, clubfoot, calcaneonavicular coalition, talocalcaneal coalition, and a ball-and-socket ankle. Patients with talonavicular coalitions are usually asymptomatic and rarely undergo surgical treatment. We report the case of a 24-year-old woman with symptomatic bilateral talonavicular coalitions and previously unreported associated anomalies (nail hypoplasia and metatarsus primus elevatus) and review the relevant literature. The patient underwent surgery (calcaneocuboid joint distraction arthrodesis and a proximal plantar flexion osteotomy with a dorsal open wedge of the first metatarsal). At 1-year followup, she was pain-free with better alignment of both feet and showed radiographic consolidation of the arthrodesis. Although this condition is less likely to be clinically important than other tarsal fusions, it sometimes can be painful enough for the patient to undergo surgery.

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Section: Discussionmentioning

confidence: 64%

Case Reports: Symptomatic Bilateral Talonavicular Coalition

Migues

Slullitel

Suárez

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…Bonk and Tozzi22 identified an acutely painful TN synostosis in an athlete. Pontious et al 5 performed objective gait analysis in a patient with a bilateral TN coalition, establishing an altered gait pattern. David et al 23 were the first to utilise a foot orthosis specifically tailored to a paediatric patient with a TN coalition.…”

Section: Discussionmentioning

confidence: 99%

“…Gait analysis has revealed that TN coalition leads to increased pressure under the first metatarsophalangeal joint, with hyperkeratosis under the first metatarsal head 5. As podiatric physicians, we believe that it is particularly important to treat hyperkeratotic lesions in patients with diabetic peripheral neuropathy because they can progress into limb-threatening ulcerations in the future.…”

Section: Introductionmentioning

confidence: 97%

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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“…Pontious et al . [7] demonstrated a high first metatarsophalangeal joint plantar pressure and diminished time in the midstance portion of stance phase in a patient with bilateral talonavicular fusions, whereas Spectore et al . [8] recorded an increase in midstance and a decrease in contact phase bilaterally in a 55‐year‐old patient with a unilteral talonavicular fusion.…”

Section: Discussionmentioning

confidence: 99%