Pediatric & adolescent flatfoot reconstruction in combination with middle facet talocalcaneal coalition resection

Surgical reconstruction of symptomatic flatfoot associated with middle facet tarsal coalition is becoming more widely used. This article demonstrates that coalition-concomitant flatfoot is a pathologic entity that is worthy of surgical management. The literature, although limited, has suggested that poor outcomes with isolated simple coalition resection may have been related to the preoperative pes planus that was not addressed. More recently studies have demonstrated improved clinical and radiographic postoperative outcomes when the flatfoot correction is combined with the coalition resection. This article reviews a surgical treatment algorithm that considers the presence of varying degrees of pes planus and rearfoot arthrosis associated with coalition.