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Resection of Talocalcaneal Coalition With Calcaneal Lengthening Osteotomy: Short-to-Intermediate-Term Results
Michael Zaidman1, Eden Weisstub1, Vladimir Goldman1
1Department of Orthopedic Surgery, Hadassah Hebrew University Medical Center, Jerusalem, ISR.
Introduction:
The optimal surgical strategy for symptomatic tarsal coalition in pediatric patients remains debated. This study assessed the clinical and radiographic outcomes of addressing symptomatic talocalcaneal coalition through a combination of coalition resection and calcaneal lengthening osteotomy. Materials and methods: We retrospectively reviewed cases of 10 children (11 feet) with symptomatic talocalcaneal tarsal coalition and painful flat feet who were treated between 2017 and 2019. All underwent calcaneal lengthening osteotomy (CLO) and coalition resection (RC). In half of the cases, the Achilles tendon was lengthened, and two children underwent medial plication. We analyzed demographic, clinical, and radiographic data, including CT scans for coalition confirmation and joint evaluations. Pre- and postoperative radiographic measurements and American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score assessed outcomes.
Results:
The cohort, averaging 13.9 years at surgery, showed significant deformity correction. At follow-up (mean 54 months), six children were pain-free, and four experienced mild pain after intense activities. AOFAS scores were excellent or good. Complications included one superficial infection and mild forefoot supination in two children. No additional surgeries were needed.
Conclusion:
Resection of talocalcaneal coalition combined with CLO effectively corrects rigid flat foot and alleviates pain, providing reliable outcomes in symptomatic cases.
