Gait abnormalities following resection of talocalcaneal coalition.

Abstract

Eleven patients (fourteen feet) had resection of a coalition of the middle facet of the talocalcaneal joint because of symptoms that had been present for a mean of four years (range, 0.5 to nine years). The mean age at the time of the resection was seventeen years (range, thirteen to thirty-two years). Nine patients were male and two were female. Five feet had resection of the bone bridge with interposition of fat or tendon, and nine had resection without any interposed material. The mean duration of follow-up was six years (range, two to thirteen years). The clinical result was excellent for five feet, good for four, fair for three, and poor for two. Inversion was 8 +/- 4.5 degrees (mean and standard deviation) on the involved side and 17 +/- 6.2 degrees on the uninvolved side (p = 0.002). Three feet later had evidence of osteoarthrosis of the subtalar joint. Gait analysis demonstrated decreased motion of the hindfoot and the ankle, compared with that in normal subjects and with that in the contralateral (uninvolved) foot, in the sagittal and coronal planes during walking on a level surface. Motion was also reduced, particularly in the sagittal and coronal planes, during walking on a side slope. Ground-reaction forces (F8 and F9), temporal force factors (T2, T3, and T7), and the percentage of the gait cycle that consisted of the stance phase on the side-sloping walkway were different from those in normal subjects or in the uninvolved foot. These data indicate that, although most of our patients who had resection of a talocalcaneal coalition had a successful clinical result, most had a residual functional deficit.