[Surgical treatment of talocalcaneal coalition].
OBJECTIVE
To explore the operative method and effectiveness of talocalcaneal coalition.


METHODS
Between July 2008 and October 2010, 10 patients with talocalcaneal coalition were treated, including 2 cases of congenital talocalcaneal coalition and 8 cases of secondary talocalcaneal coalition. There were 4 males and 6 females, aged 53.5 years on average (range, 16-70 years). Three patients had middle-facet talocalcaneal coalition and 7 had posterior-facet talocalcaneal coalition. The preoperative visual analogue score (VAS) was 9.0 +/- 0.4. According to American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scale, the score was 42.4 +/- 1.4. Two cases complicated by subtalar degeneration. Resection of the bone bar and fat packing were performed in 8 cases of simple talocalcaneal coalition, and resection and subtalar arthrodesis in 2 cases of talocalcaneal coalition combined with subtalar degeneration.


RESULTS
Primary healing of incisions was obtained in all patients. Eight patients were followed up 18 months on average (range, 12-36 months). At last follow-up, VAS was 2.0 +/- 0.7, showing siginificant difference when compared with preoperative score (t = 6.425, P = 0.000). AOFAS score was 86.9 +/- 2.3, showing significant difference when compared with preoperative score (t = 7.634, P = 0.000). The X-ray films showed that no recurrence of talocalcaneal coalition was observed in patients underdoing simple removal of bone bar, and bone fusion was observed in patients undergoing arthrodesis.


CONCLUSIONS
To achieve satisfactory outcomes for talocalcaneal coalition, a reasonable surgical procedure should be chosen according to the specific facet and complication.
Department of Orthopaedics, Tongji Hospital, Tongji University, Shanghai 200065, PR China. yuguangrong2002@yahoo.com.cn
Guangrong
G
Yu
Chunguang
C
Li
Bing
B
Li
Yunfeng
Y
Yang
Haifeng
H
Li
Jiaqian
J
Zhou
Feng
F
Yuan
D000293:Adolescent; D000328:Adult; D000368:Aged; D001174:Arthrodesis / Q000379:methods; D002111:Calcaneus / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005532:Foot Deformities, Congenital / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D013380:Subtalar Joint / Q000473:pathology / Q000601:surgery; D013580:Synostosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013628:Talus / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult