The Relative Incidence of Tarsal Coalition

Stormont, Daniel M.; Peterson, Hamlet A.

doi:10.1097/00003086-198312000-00006

Cited by 268 publications

(150 citation statements)

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“…two theories have been advanced regarding their etiology. The first belongs to Pfitzer (cited by Badgley [l], Stormont and Peterson [16], Mosier and Asher [lo]) who, secondary to his dissection, hypothesized that TC result by incorporation of accessory bones into the nearby tarsals. Pfitzer's theory was considered failed when Harris [4] demonstrated TC in foetus.…”

Section: Fig 5 Specimen 7 I Calcaneonavicular Coalition (Arrow) Cmentioning

confidence: 99%

A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet

Solomon

Rühli

Taylor

et al. 2003

Journal Orthopaedic Research

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Most of the clinical studies report the incidence of tarsal coalitions (TC) as less than 1% but they disregard the asymptomatic coalitions. TC have been associated with degenerative arthritic changes. After X-rays, computer tomography (CT) is the most commonly used diagnostic test in the detection of TC.The aims of our study were to establish the incidence of TC; the association between T C and accessory tarsal bones and between TC and tarsal arthritis; and to assess the sensitivity of CT as a diagnostic tool in TC. We performed spiral CT scans of 100 cadaver feet (mean age at death 77.7 & 10.4), which were subsequently dissected. The dissections identified nine non-osseous TC: two talocalcaneal and seven calcaneonavicular. There was no osseous coalition. Tarsal arthritis was identified in 3 1 cases. Both talocalcaneal coalitions were associated with arthritis while none of the calcaneonavicular coalitions were associated with tarsal arthritis. The CT diagnosed an osseous talocalcaneal coalition and was suspicious of fibrocartilaginous coalitions in eight cases. There was correlation between dissection and CT in two talocalcaneal coalitions and three calcaneonavicular coalitions thus CT identifying 55.50/0 of the coalitions. C T did not diagnose four non-osseous coalitions and diagnosed errouresly four possible coalitions. In conclusion our study demonstrated that the incidence of non-osseous T C is higher than previously thought ( 12.72'%). The calcaneonavicular coalitions are the most common single type (9.09%) and they d o not seem to be associated with arthritic changes in the tarsal bones. Our CT results suggest that spiral CT has a low sensitivity in the detection of non-osseous coalitions and questions if multislice CT should be used routinely when TC are suspected.Crown

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Section: Fig 5 Specimen 7 I Calcaneonavicular Coalition (Arrow) Cmentioning

confidence: 99%

A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet

Solomon

Rühli

Taylor

et al. 2003

Journal Orthopaedic Research

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“…With physical examination and radiographic evaluation alone, the authors have previously reported a bilateral calcaneonavicular coalition incidence of between 40 and 68% [4,20]. CT evaluation, however, has been shown to result in the identification of more coalitions in the asymptomatic, contralateral foot.…”

Section: Discussionmentioning

confidence: 99%

Analysis of calcaneonavicular coalitions using multi-planar three-dimensional computed tomography

Upasani

Chambers

Mubarak

2008

Journal of Children's Orthopaedics

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Purpose Computed tomography (CT) is the current imaging standard for confirming the diagnosis of a calcaneonavicular coalition. The purpose of this study was to evaluate three-dimensional (3D) multi-planar CT images of calcaneonavicular coalitions and adjacent tarsal relationships, compared to controls, in order to obtain an understanding of the 3D anatomy for classification and as an aid to surgical resection. Methods All patients who underwent CT of bilateral feet at our institution to evaluate a suspected calcaneonavicular coalition between 9/2005 and 3/2008 were retrospectively reviewed. Seventy-four feet (37 patients) were included in this analysis. In addition, 12 patients with a presumed normal calcaneonavicular relationship, who underwent CT of bilateral feet for various other diagnoses, were included as a control cohort. Seven measurements were performed on the 3D reconstructions to quantify the shape of the coalition (dorsal and plantar widths of the calcaneal and navicular contributions, coalition depth of the calcaneal and navicular contributions, and coalition length). The coalitions were classified into four types based on their appearance and their relationship to adjacent tarsal bones. Results 32/37 patients (86%) were noted to have bilateral involvement (69 coalitions). Coalitions were categorized into four types: Type I (forme fruste)-28%, Type II (fibrous)-23%, Type III (cartilaginous)-45% and Type IV (osseous)-4%. The average shape of the coalition was found to be a curved wedge, which was on average 16 mm wide dorsally, 7 mm wide on the plantar surface, 10 mm in length, and 25 mm in depth. Conclusions 3D CT reconstructions enabled the classification of the spectrum of calcaneonavicular coalitions. The shape of the cuboid was found to correlate with the extent of ossification. In Type I or II coalitions, the cuboid extended medially plantar to the fibrous connection. In more complete Type III or IV coalitions, the cuboid was ''squared off'' and remained lateral to the osseous bridge. An understanding of the 3D anatomy is important when diagnosing milder forms of coalitions, and during resection in order to avoid iatrogenic injury to the calcaneus, head of the talus, or cuboid.

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“…The overall prevalence of tarsal coalition in the general population is reported to be about 1%. [7][8][9] Since many coalitions remain asymptomatic in life, however, the actual figure may be higher. Race does not appear to be significant and, of those affected, between 50% and 60% have the condition bilaterally.…”

Section: Discussionmentioning

confidence: 99%

Talocalcaneal coalition

Sakellariou

Sallomi²,

Janzen

et al. 2000

The Journal of Bone and Joint Surgery. British volume

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With the 95% confidence interval and using the CT findings as the comparison we calculated the sensitivity, specificity, accuracy, and positive and negative predictive values for the C-sign, and for other signs known to be associated with TCC. Similarly, we also calculated the interobserver and intraobserver reliability for these signs using the kappa statistic.Our results suggest that the C-sign is highly sensitive and specific for TCC. It is an accurate indicator and significantly more reliable than other previously recognised radiological signs of TCC. Features of the C-sign, however, cannot be relied upon to indicate whether the TCC is fibrous or bony.

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The Relative Incidence of Tarsal Coalition

Cited by 268 publications

References 0 publications

A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet

A dissection and computer tomograph study of tarsal coalitions in 100 cadaver feet

Analysis of calcaneonavicular coalitions using multi-planar three-dimensional computed tomography

Talocalcaneal coalition

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