Fuentes-Nucamendi MA, Bonfil OJR, Ventura MMA

Language: Spanish
References: 12
Page: 139-145
PDF size: 290.51 Kb.

ABSTRACT

Objective: Show that the surgical release of the coalition area and the Grice subtalar arthrodesis are useful for the treatment of tarsal coalition, and describe the surgical techniques used. Material and methods: This is a prospective, longitudinal, non-randomized clinical trial conducted from January 2001 to December 2007. Patients of both genders were selected, ages 10-15 years of age, with a diagnosis of tarsal coalition without any other type of orthopedic or neurologic comorbid condition. The Harris classification of tarsal coalition was used. AP, lateral and oblique X-rays of both feet were ordered, as well as a CAT scan; the Costa-Bertani angles were measured. Central trend and scatter measurements were performed for the statistical analysis, as well as the comparison of means Z test, the relative risk (RR) and the linear correlation. Results: Twenty-six patients, 20 males and 6 females, were included in the study; 12 of them had fibrous talocalcaneal coalitions, 12 had bone coalitions and 2 had calcaneonavicular coalitions. Complications: one reflex sympathetic dystrophy, 4 superficial infections, 4 graft resorptions, and 4 patients with persistent pain. In the Z test for the Costa-Bertani angles the p value was 0.0020. The RR for obesity was 4.5, the linear correlation coefficient r for valgus hindfoot and pain was 78. Discussion: The clinical results indicate an improvement in pain and gait. Overweight was found to be a risk factor for persistent pain.

REFERENCES

1. Leonard MA: The inheritance of tarsal coalition and its relationship to spastic flat foot. J Bone Joint Surg Br 1974; 56B(3): 520-6.

2. Mosier KM, Asher M: Tarsal coalition and peroneal spastic flat foot. J Bone Joint Surg Am 1984; 66(7): 976-84.

3. Cain TJ, Hyman S: Peroneal spastic flat foot, its treatment by osteotomy of the os calcis. J Bone Joint Surg Br 1978; 60: 527-9.

4. Jayakumar S, Cowell HR: Rigid flat foot. Clin Orthop 1977; 122: 77-84.

5. Scranton PE: Treatment of symptomatic talocalcaneal coalition. J Bone Joint Surg Am 1987; 69: 533-8.

6. Raikin S, Cooperman DR, Thompson G: Interposition of the flexor hallucis longus tendon after resection of a coalition of the middle of the talocalcaneal joint. J Bone Joint Surg Am 1999; 81: 11-9.

7. Wray JB, Herdon CN: Hereditary transmission of congenital coalition of the calcaneus to the navicular. J Bone Joint Surg Am 1963; 45: 365-72.

8. Harris RI, Beath T: Etiology of peroneal spastic flat foot. J Bone Joint Surg Br 1948; 30: 624-34.

9. Pineda C, Resnick D: Diagnosis of tarsal coalition with computed tomography. Clin Orthop 1986; 208: 282-8.

10. Koeweiden EMJ, Van Empel FM, Van Horn JR, H Slooff TJJ: The heel-tip test for restricted tarsal motion. Acta Orthop Scand 1989; 60(4): 481-2.

11. Warren MJ, Jeffree MA, Wilson DJ, MacLarnon JC: Computed tomography in suspected tarsal coalition. Acta Orthop Scand 1990; 16(6): 554-7.

12. Muñoz J: Atlas de mediciones radiográficas en ortopedia y traumatología. México, Mac Graw-Hill-Interamericana, 1999: 290-1.