Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: A case report

doi:10.1016/S1067-2516(00)80050-2

The Journal of Foot and Ankle Surgery

Volume 39, Issue 5, September–October 2000, Pages 336-340

https://doi.org/10.1016/S1067-2516(00)80050-2 Get rights and content

Tensor fascia lata is utilized in the management of complex soft-tissue injuries and defects, but has not been described in the literature in the use of tissue interposition with resection of talocalcaneal middle facet coalitions. This article is a case presentation of a resection of a middle facet coalition with interposition of an allograft of tensor fascia lata. At 14 months postoperative follow-up, range of motion of the subtalar joint was noted to be 20°, and without pain or crepitus. There was no radiographic evidence of degenerative changes in Chopart's joint. The patient returned to all routine and sports activities without pain. He was satisfied with the outcome of the procedure.

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Cited by (7)

Talocalcaneal Joint Middle Facet Coalition Resection With Interposition of a Juvenile Hyaline Cartilage Graft
2015, Journal of Foot and Ankle Surgery
Citation Excerpt :
If this pathologic entity can be identified before the development of arthrosis at the surrounding joints, these young patients can undergo resection of the coalition and joint-sparing reconstruction of the concomitant pes planovalgus instead of joint destructive procedures, such as fusion, at an early age. Several interposition materials have been described in the published literature to prevent recurrence of the coalition (1,6–10,14). With the new technology of particulate juvenile cartilaginous allografts available to the foot and ankle surgeon, we can attempt to resurface the site of the coalition with a more hyaline-like cartilaginous tissue after the coalition is resected.
Talocalcaneal joint middle facet coalition is the most common tarsal coalition, occurring in ≤2% of the population. Fewer than 50% of involved feet obtain lasting relief of symptoms after nonoperative treatment, and surgical intervention is commonly used to relieve symptoms, increase the range of motion, improve function, reconstruct concomitant pes planovalgus, and prevent future arthrosis from occurring at the surrounding joints. Several approaches to surgical intervention are available for patients with middle facet coalitions, ranging from resection to hindfoot arthrodesis. We present a series of 4 cases, in 3 adolescent patients, of talocalcaneal joint middle facet coalition resection with interposition of a particulate juvenile hyaline cartilaginous allograft (DeNovo^® NT Natural Tissue Graft, Zimmer, Inc., Warsaw, IN). With a mean follow-up period of 42.8 ± 2.9 (range 41 to 47) months, the 3 adolescent patients in the present series were doing well with improved subtalar joint motion and decreased pain, and 1 foot showed no bony regrowth on a follow-up computed tomography scan. The use of a particulate juvenile hyaline cartilaginous allograft as interposition material after talocalcaneal middle facet coalition resection combined with adjunct procedures to address concomitant pes planovalgus resulted in good short-term outcomes in 4 feet in 3 adolescent patients.
Bilateral Single-stage Middle Facet Talocalcaneal Coalition Resection Combined with Flatfoot Reconstruction: A Report of 3 Cases and Review of the Literature. Investigations Involving Middle Facet Coalitions-Part 1
2008, Journal of Foot and Ankle Surgery
Citation Excerpt :
Last, Wilde et al (30) documented the association of hindfoot valgus greater than 16° with poor outcomes. Isolated subtalar fusion or triple arthrodesis remains the definitive treatment in patients with advanced degeneration, despite the fact that this form of intervention is not without a range of short and long-term sequelae (12, 18, 23, 26, 33, 34). Because triple arthrodesis is thought to cause an increased incidence of ankle and midfoot arthrosis, one should attempt to delay joint destructive interventions, especially in young patients (1, 35–39).
Talocalcaneal middle facet coalitions are associated with rigid pes planovalgus that often requires surgical intervention. Simple resection of the coalition is preferred for symptomatic cases in the absence of rearfoot arthritis. While resection of the coalition will remove the osseous restriction of motion and may eliminate pain, the procedure does not specifically correct the concomitant pes planovalgus. In this report of 6 feet in 3 patients, we advocate combining resection of the coalition with concomitant flatfoot reconstruction in a single-stage operation. The patients in this series averaged 13.67 (range 12–17) years of age at the time of their foot surgeries, and their follow-up averaged 30 (range 16–54) months. All of the patients displayed bilateral middle facet talocalcaneal coalitions and underwent bilateral resection combined with flatfoot reconstruction. Each patient had 1 foot corrected followed by a period of at least 6 months before the contralateral foot was corrected. The mean postoperative American Orthopaedic Foot and Ankle Society ankle-hindfoot score was excellent (94.33 ± 2.81 points) overall. The median radiographic values for calcaneal inclination, Meary's, and anteroposterior talar-first metatarsal angles demonstrated statistically significant improvements: 9° (3°, 13°) (P = .0273), 4° (2°, 7°) (P = .0269), and 6° (3°, 11°) (P = .0277), respectively, and all feet demonstrated improved subtalar joint motion without pain. Although long-term results remain to be determined in a larger cohort, it is hoped that this combined approach to talocalcaneal coalition will delay or obviate future rearfoot arthrosis and the need for arthrodesis. Level of Clinical Evidence: 4.
"False sprain" of the adolescent
2006, Journal de Traumatologie du Sport
Les coalitions des os du tarse ou synostoses des os du tarse sont des malformations congénitales liées à un défaut de segmentation des maquettes cartilagineuses. Elles peuvent être partielles ou complètes, fibreuses, cartilagineuses ou osseuses.
Les formes les plus fréquentes intéressent les articulations talo-calcanéenne et naviculo-calcanéenne. Le bec calcanéen trop long est une entité particulière que l’on assimile à ces coalitions.
Elles deviennent généralement symptomatiques au moment de l’adolescence et sont responsables de tableaux d’entorses de la cheville à répétition.
La présentation clinique typique est le pied-plat contracturé et douloureux et la mobilisation de ce pied retrouve une raideur sous-talienne et du médio-pied.
Les clichés radiographiques standard permettent de suspecter ces coalitions. Le diagnostic est affirmé sur des incidences obliques déroulées et surtout sur des coupes scannographiques.
Le traitement de première intention est orthopédique et, en cas d’échec, la résection de la coalition apporte d’excellents résultats. En cas de synostose talo-calcanéenne étendue ou compliquée, une arthrodèse sous-talienne doit être proposée.
Tarsal coalitions are congenital malformations related to a segmentation defect of the primitive structures. They can be complete or incomplete, fibrous, cartilaginous or bony.
The most frequent types are those involving the talocalcaneal and the calcaneonavicular joint. The too long anterior process of the calcaneum is a separate entity which is related to these coalitions.
They usually become symptomatic during adolescence and are responsible for repetitive sprain of the ankle joint. The typical clinical presentation is a peroneal spastic and painful flatfoot and there is a subtalar and tarsal joint stiffness.
Tarsal coaltions can be suspected on standard X ray. The diagnosis can be confirmed on Xray oblique views and especially on CT scan.
The initial treatment is usually conservative and in case it fails, the resection of the tarsal coalition gives good results. In severe cases of talocalcaneal coalition, a subtalar arthrodesis is preferred.
Progress in Diagnosis and Treatment of the Calcaneonavicular Coalition
2019, Chinese General Practice
Clinical applications of allografts in foot and ankle surgery
2019, Knee Surgery, Sports Traumatology, Arthroscopy
Resection of Medial Talocalcaneal Coalition With Interposition of a Pediculated Flap of Tibialis Posterior Tendon Sheath
2018, Foot and Ankle International

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Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: A case report

Clin. Radiol.

Br. J. Plast. Surg.

J. Oral Maxillofac. Surg.

J. Urol.

Rigid flatfoot

Clin. Orthop.

Surgical management of tarsal coalition in adolescent athletes

Foot Ankle Int.

Treatment of symptomatic talocalcaneal coalition

J. Bone Joint Surg.

Tarsal coalitions: long-term results of surgical treatment

J. Pediatr. Orthop.

Symptomatic talocalcaneal coalition, its clinical significance and treatment

Clin. Orthop.

Tarsal coalition

Foot Ankle Int.

Osseous and non-osseous coalition of the middle facet of the talocalcaneal joint

J. Bone Joint Surg.

The relative incidence of tarsal coalition

Clin. Orthop.

Tarsal coalition: depiction and characterization with CT and MR imaging

Radiology

New nonfusion procedure for talocalcaneal coalitions with a fixed heel valgus

J. Am. Podiatr. Med. Assoc.