Preliminary report: resection and interposition of a deepithelialized skin flap graft in tarsal coalition in children

Sperl, Matthias; Saraph, Vinay; Zwick, Ernst B.; Kraus, Tanja; Spendel, Stephan; Linhart, Wolfgang E.

doi:10.1097/bpb.0b013e3283356256

Cited by 21 publications

(18 citation statements)

References 33 publications

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“…(13,45) Currently, there is no complete agreement concerning the best surgical strategy in children with RFF and TCC. Recommended treatments include bar resection alone or combined with tissue interposition and hindfoot correction, (5,8,19,24,26,29,33,36,(39)(40)(41)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62) isolated calcaneal osteotomy, (13) subtalar fusion or triple arthrodesis; the latter being recommended for subtalar OA, failure of previous surgeries, or large irresectable coalitions with severe heel valgus. (17,18,39,46) The known poor long-term outcomes of triple arthrodesis, however, make this an undesirable option, particularly for children.…”

Section: Discussionmentioning

confidence: 99%

“…(1) The talocalcaneal coalition (TCC) and the calcaneo-navicular coalition (CNC) are the most frequent compared to other types. (7,8) Many patients with TCC typically show a rigid flatfoot (RFF) with loss of the medial arch. (5,9) RFF must be distinguished from flexible flatfoot (FFF).…”

Section: Introductionmentioning

confidence: 99%

“…(17,18) More recently, some authors reported good results following bar resection, possibly associated with interposition of various tissues. (8,(19)(20)(21)(22)(23)(24) This treatment aims to relieve pain and increase subtalar motion.…”

Section: Introductionmentioning

confidence: 99%

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Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Gennaro

Stallone

Olivotto

et al. 2020

Preprint

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Background: The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods:We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis.Results: Thirty-four Children (47 feet) in the nonoperative group and twenty-one children (34 feet) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9-17): 11.6 (9-17) for the nonoperative group, 12.2 (10-15) for the operative group. The mean follow-up averaged 6.6 (3-12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years; p < 0.0005), since the operative procedure was increasingly practiced in the latest years.There were no complications in either groups, but 6 patients (7 feet) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusion:The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition. BackgroundThe congenital tarsal coalition is a partial or complete fusion between two or more midfoot or hindfoot bones, due to abnormal formation of bone, cartilage or fibrous tissue. (1) The incidence of tarsal coalition is about 1%, although, being often asymptomatic, the true

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Gennaro

Stallone

Olivotto

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…(13,45) Currently, there is no complete agreement concerning the best surgical strategy in children with RFF and TCC. Recommended treatments include bar resection alone or combined with tissue interposition and hindfoot correction, (5,8,19,24,26,29,33,36,(39)(40)(41)(46)(47)(48)(49)(50)(51)(52)(53)(54)(55)(56)(57)(58)(59)(60)(61)(62) isolated calcaneal osteotomy (13), subtalar fusion or triple arthrodesis; the latter being recommended for subtalar OA, failure of previous surgeries, or large irresectable coalitions with severe heel valgus. (17,18,39,46) The known poor long-term outcomes of triple arthrodesis, however, make this an undesirable option, particularly for children (16).…”

Section: Discussionmentioning

confidence: 99%

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Gennaro

Stallone

Olivotto

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods: We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis. Results: Thirty-four Children (47 feet) in the nonoperative group and twenty-one children (34 feet) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9-17): 11.6 (9-17) for the nonoperative group, 12.2 (10-15) for the operative group. The mean follow-up averaged 6.6 (3-12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years; p < 0.0005), since the operative procedure was increasingly practiced in the latest years. There were no complications in either groups, but 6 patients (7 feet) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusions: The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition.

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“…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 .…”

Section: Discussionunclassified

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

Becerrica

Pedro

Ortega

et al. 2016

Rev. Int. Cienc. Podol.

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Resumen. Las coaliciones tarsales (unión fibrosa, cartilaginosa u ósea congénita entre dos huesos) a menudo son asociadas a una deformidad de pie plano en niños. Normalmente se presenta con esguinces de tobillo recurrentes o con inicio insidioso de un pie plano rígido doloroso y con limitación al movimiento de las articulaciones mediotarsianas y subastragalina. El diagnóstico clínico se confirma con radiografía, tomografía axial computerizada (TAC) y resonancia magnética nuclear (RMN). El signo de la nariz del oso hormiguero es causado por un alargamiento tubular del proceso anterior del calcáneo que se acerca o se superpone con el escafoides tarsiano y se asemeja a la nariz de un oso hormiguero en una radiografía lateral del pie o tobillo. El tratamiento de esta unión es primeramente sintomático, pero si el dolor persiste debe ser quirúrgico. Se presenta el caso de un niño de 10 años con coalición calcáneo-navicular bilateral asociada a pie plano valgo rígido. Palabras clave: Coalición tarsal; pie plano; niños; diagnóstico; tratamiento.[en] Calcaneus-navicular coalition associated to flatfoot in a child. A case report Abstract. Tarsal coalition (a congenital fibrous, cartilaginous or bony connection between two bones) often leads to a flatfoot deformity in children. Usually it presents with recurrent ankle sprains or insidious onset of a painful rigid flatfoot and movement limitation of midtarsal and subtalar joints. Clinical diagnosis is confirmed by X-rays, computed axial tomography and nuclear magnetic resonance. The anteater nose sign is caused by a tubular elongation of the anterior process of the calcaneus that approaches or overlaps the tarsal scaphoid (navicular) and resembles the nose of an anteater on a lateral foot or ankle radiograph. The treatment of this union is primarily symptomatic but if the pain persists must be surgical. For a child of 10 years with bilateral calcaneus -navicular coalition associated with valgus rigid flatfoot arises.

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Preliminary report: resection and interposition of a deepithelialized skin flap graft in tarsal coalition in children

Cited by 21 publications

References 33 publications

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

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

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