title: Patient-specific instruments for surgical resection of painful tarsal coalition in adolescents.
abstract: BACKGROUND
  Congenital tarsal coalition resection in adolescents may be hindered by the complex three-dimensional anatomy of the talocalcaneal joint. Peroperative fluoroscopy is not greatly contributive, especially for talocalcaneal coalition.
  
  
  OBJECTIVE
  3D planning and patient-specific instruments facilitate the procedure.
  
  
  METHODS
  A made-to-measure surgical guide (patient-specific instrument) was used in 9 consecutive patients for tarsal coalition resection (7 talocalcaneal and 2 calcaneonavicular coalitions). The guide was created by 3D modeling from the CT scan of the foot. Placed on the bone surface, it oriented the saw blade to resect the bone bridge at the appropriate depth. A fascia lata allograft was interposed. Complete resection and absence of recurrence were checked on postoperative CT in talocalcaneal and on radiography in calcaneonavicular coalitions.
  
  
  RESULTS
  Resection was complete in all cases, with no recurrence at last follow-up.
  
  
  CONCLUSIONS
  This technique makes tarsal coalition resection easier and more reliable and may be recommended to improve precision.
  
  
  METHODS
  Level IV, prospective study of a new surgical technique.
authors.affiliation: Cliniques Universitaires Saint-Luc, Service de Chirurgie Orthopédique et Traumatologique, avenue Hippocrate 10, 1200 Brussels, Belgium; Computer Assisted and Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, avenue Mounier 53, 1200 Brussels, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: de Wouters
authors.affiliation: Centis Engineering, Université Catholique de Louvain (UCL), Institute of Mechanics, Materials and Civil Engineering (IMMC), SST/IMMC/MCTR, Louvain-la-Neuve, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Tran Duy
authors.affiliation: Cliniques Universitaires Saint-Luc, Service de Chirurgie Orthopédique et Traumatologique, avenue Hippocrate 10, 1200 Brussels, Belgium; Computer Assisted and Robotic Surgery (CARS), Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, avenue Mounier 53, 1200 Brussels, Belgium. Electronic address: pierre-louis.docquier@uclouvain.be.
authors.forename: P-L
authors.initials: PL
authors.lastname: Docquier
mesh_terms: D000293:Adolescent; D002648:Child; D003198:Computer Simulation; D005532:Foot Deformities, Congenital / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D021621:Imaging, Three-Dimensional; D013380:Subtalar Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation*; D013580:Synostosis / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
keywords: Congenital tarsal synostosis; Patient-specific instrument; Tarsal coalition