The talocalcaneal coalition can be fibrous syndesmosis, cartilaginous. Recovery depending upon the type and location of your surgery, a cast will be required for a period of time to protect the surgical site and prevent you from putting weight on the foot. Excision of calcaneonavicular tarsal coalition youtube. This book is distributed under the terms of the creative commons. Arthroscopic resection of talocalcaneal coalitions arthroscopy. The surgical alternatives for the treatment of tarsal coalitions include procedures as. Tarsal coalition describes the complete or partial union between two or more bones in the midfoot and hindfoot. Examination and management of a patient with tarsal coalition. Current clinical aspects with introduction of a surgical classification michael s. It typically presents in late childhood or adolescence as a painful, rigid flatfoot. Tarsal coalition refers to developmental fusion rather than fusion that is acquired secondary to conditions such as rheumatoid arthritis, trauma or postsurgical. The anesthesia and patient positioning are the same. Because tarsal coalition is a structural boney problem the underlying issue where bones are fused together, the nonsurgical measures for tarsal coalition are aimed at decreasing andor eliminating symptoms pain. Essential considerations in choosing a surgical procedure.
Current concepts in tarsal coalition surgery podiatry today. Therefore, a tarsal coalition is better termed as either complete i. Nonsurgical treatment the goal of nonsurgical treatment of tarsal coalition is to relieve the symptoms and reduce the motion at the affected joint. One or more of the following options may be used, depending on the severity of the condition and the response to treatment. For extraarticular coalitions, such as the calcaneonavicular bar, the tissue composition and size of the coalition seem to have little bearing on the ultimate surgical approach. Resection as a method of treatment of tarsal coalitions. Talocalcaneal coalitions unresponsive to conservative treatment are best managed by coalition excision, although outcomes are not as good as those after. Calcaneonavicular and talocalcaneal coalitions are the most common types. The talocalcaneal coalition can be fibrous syndesmosis. This video shows the steps used to perform a tarsal.
We propose a novel operative technique utilizing realtime operative. If symptomatic, surgical treatment of the coalition is often necessary. Patientreported outcomes of tarsal coalitions treated. Live tarsal tunnel and baxters nerve surgery narrated by dr. We present a technique to optimize surgical resection of talocalcaneal coalitions by using kirschner wires inserted from the lateral side, which allows us to demarcate the coalition. In fusion for tarsal coalition, the bones may be held in place with large screws, pins, or screwandplate devices. A tarsal tunnel release also called a decompression or external neurolysis is the procedure used to treat tarsal tunnel syndrome. Initial, nonoperative management for symptomatic tarsal coalition. As a result, resection of talocalcaneal coalitions is becoming more common, and optimizing the surgical technique is a necessity in the field of orthopedics. The included patients had undergone surgical excision of a subtalar tarsal coalition, preoperative computed tomography ct, and patientbased outcomes measures after surgery including the. Year chapter article title author the podiatry institute. Subtalar coalition resection utilizing live navigation. Excision of symptomatic talocalcaneal coalitions, after failure of an adequate conservative.
Mcglamrys comprehensive textbook of foot and ankle surgery, 3rd ed. This technique makes tarsal coalition resection easier and more reliable and may be recommended to improve precision. But not all tarsal coalitions require surgery, so there are useful treatment techniques. Tarsal coalition is an abnormal connection between adjacent bones in the foot. However, the surgeon makes the incision medially over the sustentaculum tali.
Patientspecific instruments for surgical resection of painful tarsal. Excision of symptornatic coalition of the niiddlc facet of the talocalcaneal joint. Proms after surgical excision of a tarsal coalition reveal that over 70% of patients. Describe the surgical technique of talocalcaneal coalition resection using live ct. The surgical technique for resection of a middle facet tc coalition resection is similar to the aforementioned cn technique.