Tarsal coalition resection in children: Is it effective?

Area of Science:

• Pediatric Orthopedics
• Foot and Ankle Surgery
• Musculoskeletal Disorders

Background:

• Tarsal coalitions in children often manifest as rigid flatfoot, necessitating surgical intervention.
• Surgical options include coalition resection alone or combined with reconstructive procedures.

Purpose of the Study:

• To assess the complication rates and identify risk factors for adverse outcomes after surgical management of pediatric tarsal coalitions.
• To evaluate the incidence of infection, recurrence, and reoperation following tarsal coalition resection.

Main Methods:

• Retrospective cohort study analyzing electronic health records and chart reviews from 2008-2019.
• Included 165 feet from 144 pediatric patients who underwent tarsal coalition resection.
• Collected data on demographics, clinical characteristics, perioperative factors, and subsequent procedures.

Main Results:

• Overall postoperative complication rate was 10.9% (18/165 feet).
• Complications included infection (6), recurrence (6), and other reoperations (6).
• Risk factors for complications were increased age at surgery (13.9 vs 12.4 years), obesity, and preoperative hindfoot valgus.

Conclusions:

• Surgical management of pediatric tarsal coalitions carries a notable complication rate.
• Identifying patients with risk factors like older age, obesity, and hindfoot valgus is crucial for preoperative counseling.
• Findings aid in discussing treatment approaches and expected outcomes with patients and families.