Tarsal coalition and painful plano-valgus foot. Deformity correction as alternative to resection

Abstract

Aim. The study aimed to evaluate a group of patients who underwent consecutive surgeries between 2007 and 2020 due to a painful coalition of the tarsal bones, focusing exclusively on correcting valgus foot deformity. Materials and methods. A retrospective clinical and radiographic analysis was conducted on 11 adolescents (13 feet) who underwent surgery for talonavicular or talocalcaneal coalition combined with valgus deformity. Age at surgery ranged from 12 to 21 years. In each patient, the procedure involved performing opening wedge osteotomy of the anterior part of the calcaneus along with gastrocnemius muscle lengthening, with no coalition removal. The calcaneal osteotomy, using an autograft from the lateral malleolus, did not require stabilization. Two patients were operated on bilaterally. Before the surgeries, all the patients had painful valgus and abduction deformity and/or flatfoot with restriction of subtalar motion. Follow-up ranged from 2 to 14 years (mean 6). Results. Pain relief and foot shape improvement were achieved in all patients who underwent the procedure. Conclusion. In adolescents and young adults, deformity correction and improvement in foot shape without coalition resection alleviates the pain associated with the defect.

Keywords

• tarsal coalition
• calcaneal lengthening osteotomy
• opening wedge osteotomy of calcaneus
• Evans osteotomy