Abstract
Talocalcaneal coalition often leads to a flatfoot deformity in children. Previous reports have uncovered many aspects of tarsal coalition and flatfoot respectively, including the etiology, clinical presentation, and diagnostic imaging, as well as treatment. However, the optimum surgical procedure for talocalcaneal coalition combined with flatfoot has not been definitively determined. The nonconformity of treatment options is due to our incomplete knowledge of biomechanics, diagnosis, and indication of treatment for talocalcaneal coalition with flatfoot. The objectives of this review are to provide an overview of the current knowledge about etiology, biomechanics, classification, diagnosis, and treatment options for talocalcaneal coalitions with flatfoot and highlight its therapies in children.
Highlights
Tarsal coalition is an abnormal connection between the tarsal bones, which is thought to result from a congenital failure of differentiation in the developing fetal foot
We present the existing knowledge on the etiology, classification, diagnosis, and treatment of the talocalcaneal coalitions with flatfoot and debate whether there is an optimal surgical procedure
Giannini reported that arthroereisis by implanting a bioreabsorbable device after resection of the tarsal coalition seems to restore the alignment of the hindfoot and reduce pain effectively for symptomatic flatfoot associated with talocalcaneal coalitions [57]
Summary
Tarsal coalition is an abnormal connection between the tarsal bones, which is thought to result from a congenital failure of differentiation in the developing fetal foot. Treatment options The goal of conservative treatment for patients with talocalcaneal coalition and flatfoot is to limit subtalar and midtarsal joint range of motion in an effort to reduce pain and muscle spasms. A single resection of coalition for intractably painful small talocalcaneal coalition that is associated with a wide, healthy posterior facet and minimal valgus deformity of the hindfoot. Hindfoot valgus and pes planovalgus deformities did not correct well after single resection of talocalcaneal coalitions [33,48] These are due to the secondary effect of soft tissue contractures (lateral ligaments, peroneal tendons, calf muscles) ? Giannini reported that arthroereisis by implanting a bioreabsorbable device after resection of the tarsal coalition seems to restore the alignment of the hindfoot and reduce pain effectively for symptomatic flatfoot associated with talocalcaneal coalitions [57]. Two operative criteria should be noticed for a long-term outcome: first, do not disturb the growth of the talocalcaneal joint; second, to correct the deformity combining resection of the coalition in a single-stage operation
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