SURGICAL RESECTION OF TARSAL COALITION – A LONG TERM FOLLOW-UP

Abstract

Introduction: Many surgeons recommend surgical resection of symptomatic tarsal coalition. The success of this procedure in reducing symptoms has been well described in the literature, but long term results remain scarce. In 1967 Mitchell et al described a series of 41 resections of calcaneonavicular coalition with an average 6 year follow up. In 1990 Gonzalez et al described two groups who underwent a total of 75 resections of calcaneonavicular coalition by multiple surgeons. We describe the largest combined series of calcaneonavicular and talocalcaneal coalition resection with a minimum follow up of 3 years and a maximum of 12 years (average 9.5 years).

Methods: We retrospectively studied the clinical results of a consecutive series of 79 primary resections for tarsal coalition in 63 patients carried out by the senior author over a 12 year period. A standard resection procedure was performed in each case. Duration of symptoms, side of maximal symptoms, activity level, family history, peroneal spasm, and patient weight preoperatively was recorded retrospectively using medical records. Visual analogue pain scores, analgesia requirement, activity level, time to return to maximum activity, occupation, patient and parent satisfaction level, peroneal spasm, range of motion, AOFAS ankle-hindfoot score, and patient body mass index was recorded at follow up.

Results: At follow up the majority of patients had mild or no pain and did not require regular analgesia, had some limitation of recreational activities but not of daily activities, and had some stiffness. The majority of patients and parents were satisfied with the outcome.

Discussion: Resection of tarsal coalition is recommended when symptomatic but also is recommended bilaterally when present regardless of symptomatology of the lesser affected foot.