title: Tarsal Coalitions: Preliminary Results After Operative Excision and Silicone Sheet Interposition in Children.
abstract: Symptomatic tarsal coalitions that begin in early adolescence are usually treated by resection and interposition (fat, muscle, or bone wax) to prevent recurrence. The purpose of the present retrospective study was to describe our operative technique and report our clinical and radiologic outcomes with sterile silicone sheet interposition after resection of painful tarsal coalitions in 4 children (4 feet). The present series included 1 case of talocalcaneal synchondrosis and 3 of synostosis (2 talocalcaneal and 1 cuboid-navicular). Two validated functional scales were used to assess the patients' overall outcome and satisfaction with the procedure: the American Orthopaedic Foot and Ankle Society ankle-hindfoot score and the Foot Function Index. Conventional radiography, computed tomography with 3-dimensional reconstruction, and magnetic resonance imaging were performed at the final follow-up visit. The mean follow-up period was 40 (range 12 to 80) months. The mean age at surgery was 10.5 (range 8 to 13) years. All patients had achieved their desired activity level at 6 months postoperatively. The mean American Orthopaedic Foot and Ankle Society ankle-hindfoot score was 93.5 (range 74 to 100), and the mean Foot Function Index was 3.25% (range 0% to 13%). No recurrence of the coalition on imaging at the final follow-up visit was observed in this patient series. Sterile silicone sheet interposition can be used to prevent recurrence of tarsal coalition in symptomatic tarsal coalitions after failure of conservative management.
authors.affiliation: Surgeon, Department of Pediatric Orthopaedic Surgery, Amiens University Hospital and Jules Verne University of Picardy, Amiens, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Krief
authors.affiliation: Surgeon, Department of Pediatric Orthopaedic Surgery, Amiens University Hospital and Jules Verne University of Picardy, Amiens, France.
authors.forename: Linda
authors.initials: L
authors.lastname: Ferraz
authors.affiliation: Surgeon, Department of Pediatric Orthopaedic Surgery, Amiens University Hospital and Jules Verne University of Picardy, Amiens, France.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Appy-Fedida
authors.affiliation: Surgeon, Department of Pediatric Orthopaedic Surgery, Amiens University Hospital and Jules Verne University of Picardy, Amiens, France.
authors.forename: François
authors.initials: F
authors.lastname: Deroussen
authors.affiliation: Surgeon, Department of Pediatric Orthopaedic Surgery, Amiens University Hospital and Jules Verne University of Picardy, Amiens, France.
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Plancq
authors.affiliation: Professor, Department of Pediatric Orthopaedic Surgery, Amiens University Hospital and Jules Verne University of Picardy, Amiens, France.
authors.forename: Louis-Michel
authors.initials: LM
authors.lastname: Collet
authors.affiliation: Professor, Department of Pediatric Orthopaedic Surgery, Amiens University Hospital and Jules Verne University of Picardy, Amiens, France. Electronic address: richard.gouron@gmail.com.
authors.forename: Richard
authors.initials: R
authors.lastname: Gouron
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D010027:Osteotomy; D012189:Retrospective Studies; D012828:Silicones; D000070604:Tarsal Coalition / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D012828:Silicones
keywords: Downey classification; calcaneus; children; cuboid; navicular; talus