Experimental model in cadavera of arthroscopic resection of calcaneonavicular coalition and its first in-vivo application: preliminary communication

Abstract

Open surgical resection of calcaneonavicular coalition is indicated after the failure of conservative treatment. Our objectives are to develop the arthroscopic surgical technique and to check the feasibility of the arthroscopic resection of the calcaneonavicular coalition. We designed and performed endoscopic resection of the calcaneonavicular ligament and part of the anterior process of calcaneus as a simulation of the coalition resection on four cadaver specimens. After this procedure, we successfully performed the first resection in a 12-year-old girl, without any soft tissue interposition. American Orthopaedic Foot and Ankle Society Hindfoot Scale was 55 before surgery, 98 after 10 weeks, and 100 after 2 years without recurrence.

Coalición calcáneo-navicular asociada a pie plano rígido infantil. A propósito de un caso

“…Refiriéndonos a la coalición calcáneo-escafoidea, se recomienda realizar la incisión quirúrgica en el seno del tarso, resecar la barra e interponer algún tejido para evitar la recidiva; se ha descrito la colocación de tejido graso, fibras musculares del extensor corto de los dedos (técnica de Cadwell) e inclusive un colgajo de piel desepitelizada 27 . Bernardino reportó un caso tratado con resección de la barra mediante artroscopia sin la colocación de ningún tejido en el sitio de la resección, con lo que obtuvo resultados excelentes a dos años de seguimiento y sin recidiva del padecimiento 24 . Cuando la coalición astrágalo-calcánea se ha tratado simplemente mediante resección, se han reportado resultados pobres 13,28,29 debido a los altos porcentajes de recidiva, ya que la téc-nica es demandante y frecuentemente se hace sólo una resección parcial de la barra.…”

The Evaluation and Treatment of Pediatric Tarsal Coalitions

“…Andreasen reported that this technique was associated with satisfactory outcomes for twenty-two of thirty patients who were followed for as long as twenty-two years postoperatively 52 , Chambers et al noted a 100% rate of satisfactory results in a study of twenty-nine patients who were followed for three to fourteen years 55 , Cowell reported good or excellent outcomes for twenty-three (88%) of twenty-six patients 56 , and Gonzalez and Kumar reported good to excellent outcomes for fifty-eight (77%) of seventyfive patients who were followed for an average of three years following resection and interposition 54 . A minimally invasive method of performing a coalition resection with use of arthroscopy 57,58 recently has received attention, with good short-term results being observed in studies involving very small sample sizes 59 . The main concern regarding arthroscopic resection involves adequate identification of the deeper aspect of the osseous coalition bridge, which, if not adequately resected, can facilitate recurrence of coalition.…”

Talocalcaneal coalition combined with flatfoot in children: diagnosis and treatment: a review

“…Recently, posterior arthroscopic technique for posterior-facet talocalcaneal coalition excision has been developed [ 38 , 39 ]. In the prone position, Bonasia introduced two portals, posterolateral (PL) portal and posteromedial (PM) portal for resection of talocalcaneal coalition [ 38 ].…”