Calcaneonavicular coalition resection with extensor digitorum brevis interposition in adults

Area of Science:

• Orthopedic Surgery
• Foot and Ankle Reconstruction
• Skeletal Dysplasias

Background:

• Calcaneonavicular coalition is a common cause of pediatric flatfoot.
• Surgical resection with extensor digitorum brevis interposition is standard for pediatric patients.
• Adults and patients with osseous coalitions often undergo joint-sacrificing arthrodesis due to surgeon reluctance.

Purpose of the Study:

• To evaluate the efficacy of calcaneonavicular coalition resection with extensor digitorum brevis interposition in adult patients.
• To assess long-term outcomes, including functional scores and patient satisfaction.
• To compare this procedure to traditional arthrodesis in adults.

Main Methods:

• Seven adult patients (eight feet) with symptomatic calcaneonavicular coalitions underwent resection and extensor digitorum brevis interposition.
• Patients had an average age of 41 years and no radiographic evidence of arthritis.
• Outcomes were assessed via physical and radiographic evaluations, American Orthopaedic Foot and Ankle Society (AOFAS) scores, complication review, and patient satisfaction surveys.

Main Results:

• Mean follow-up was 56.5 months with an average AOFAS score of 87.
• No degenerative changes or coalition recurrence were observed radiographically.
• All patients reported willingness to undergo the surgery again and recommend it, with low complication rates (one superficial infection, one dysesthesia).

Conclusions:

• Resection with muscular interposition is a successful surgical option for adults over 18 with symptomatic calcaneonavicular coalitions unresponsive to conservative care.
• This procedure provides an effective alternative to arthrodesis with a low complication rate.
• High patient satisfaction and favorable long-term radiographic results support its use in adult populations.