[The Grice technique for tarsal coalition].
OBJECTIVE
Show that the surgical release of the coalition area and the Grice subtalar arthrodesis are useful for the treatment of tarsal coalition, and describe the surgical techniques used.


METHODS
This is a prospective, longitudinal, non-randomized clinical trial conducted from January 2001 to December 2007. Patients of both genders were selected, ages 10-15 years of age, with a diagnosis of tarsal coalition without any other type of orthopedic or neurologic comorbid condition. The Harris classification of tarsal coalition was used. AP, lateral and oblique X-rays of both feet were ordered, as well as a CAT scan; the Costa-Bertani angles were measured. Central trend and scatter measurements were performed for the statistical analysis, as well as the comparison of means Z test, the relative risk (RR) and the linear correlation.


RESULTS
Twenty-six patients, 20 males and 6 females, were included in the study; 12 of them had fibrous talocalcaneal coalitions, 12 had bone coalitions and 2 had calcaneonavicular coalitions.


RESULTS
one reflex sympathetic dystrophy, 4 superficial infections, 4 graft resorptions, and 4 patients with persistent pain. In the Z test for the Costa-Bertani angles the p value was 0.0020. The RR for obesity was 4.5, the linear correlation coefficient r for valgus hindfoot and pain was 78.


CONCLUSIONS
The clinical results indicate an improvement in pain and gait. Overweight was found to be a risk factor for persistent pain.
Fuentes-Nucamendi
Marcos Alfonso
MA
Hospital General de México, OD, Servicio de Ortopedia Pediátrica. fuentesnucamendi@yahoo.com.mx
Bonfil Ojeda
Juan Ramón
JR
Ventura Martínez
Marco Antonio
MA
D000293:Adolescent; D001174:Arthrodesis / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013639:Tarsal Bones / Q000002:abnormalities* / Q000601:surgery*