title: Taking out the tarsal coalition was easy: but now the foot is even flatter. What now?
abstract: Patients with a preexisting hindfoot deformity, who undergo resection (with or without soft tissue interposition) of a tarsal coalition, may present with recurrent pain and worsening planovalgus deformity. This is due to the secondary effect of soft tissue contractures (lateral ligaments, peroneal tendons, calf muscles) "pulling" the foot into more valgus. Physiotherapy and insoles may help some patients. Depending on the flexibility of the hindfoot and the presence or otherwise of joint degeneration, joint-preserving corrective procedures or corrective joint fusions may be needed. Gastrocnemius, Achilles, and/or peroneal tendon releases may be required, to avoid equinus or further recurrence.
authors.affiliation: Department of Trauma & Orthopaedics, Frimley Park Hospital NHS Foundation Trust, Portsmouth Road, Camberley, Surrey GU16 7UJ, UK.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Gougoulias
authors.affiliation: Department of Trauma & Orthopaedics, Royal Surrey County Hospital and Frimley Park Hospital, Egerton Road, Guildford, Surrey GU2 7XX, UK.
authors.forename: Maurice
authors.initials: M
authors.lastname: O'Flaherty
authors.affiliation: Department of Trauma & Orthopaedics, Frimley Park Hospital NHS Foundation Trust, Portsmouth Road, Camberley, Surrey GU16 7UJ, UK. Electronic address: anthony.sakellariou@fph-tr.nhs.uk.
authors.forename: Anthony
authors.initials: A
authors.lastname: Sakellariou
mesh_terms: D005413:Flatfoot / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D005532:Foot Deformities, Congenital / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011859:Radiography; D013639:Tarsal Bones / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery
keywords: Arthrodesis; Calcaneal osteotomy; Planovalgus; Tarsal coalition