Journal of the Pediatric Orthopaedic Society of North America (May 2024)
Talocalcaneal coalition resection
Abstract
ABSTRACT: Persistently symptomatic talocalcaneal coalitions (TCCs) may require surgical intervention. Aiming to enhance treatment outcomes, this paper describes the precise clinical and radiographic assessment (including advanced imaging) of a foot with a TCC, the indications for surgery, the detailed surgical resection technique, and the appropriate postoperative care. Key Concepts: (1) It is important to confirm the precise location(s) of foot and ankle pain in a foot with a TCC. (2) A CT scan in all 3 planes and with 3D reconstruction is needed for comprehensive preoperative planning. Assessment of the foot with a TCC includes determining if other coalitions exist in the foot. (3) Surgical management is based on the health/thickness of the posterior facet and the alignment of the hindfoot. (4) Successful coalition resection is confirmed by visualizing vertical distraction of the posterior facet and an increase in inversion/eversion of the subtalar joint intraoperatively.