scholarly journals Treatment of isolated talonavicular coalition: Case report and literature review

2018 ◽  
Vol 46 (12) ◽  
pp. 5322-5330
Author(s):  
Xiaojun Duan ◽  
Liu Yang
Keyword(s):  
Growth Period ◽  
Nonoperative Treatment ◽  
Ankle Arthritis ◽  
Ankle Pain ◽  
Tarsal Coalition ◽  
Talocalcaneal Coalition ◽  
First Case ◽  
Tarsal Bones ◽  
Late Growth

Tarsal coalition refers to an abnormal fibrous, cartilaginous, or bony connection that develops between two or more tarsal bones. Talocalcaneal coalition and calcaneonavicular coalition account for more than 90% of all cases of tarsal coalition. Coalition exists early at birth, but bony connection usually develops during the patient’s late growth period. Isolated cases of talonavicular coalition have rarely been reported. We herein report a case involving an 11-year-old patient with an isolated talonavicular coalition from a soft tissue to bony connection who was treated with arthroscopy for ankle arthritis. To our knowledge, this is the first case in which the whole formation of the talonavicular coalition was observed with a series of radiographic and magnetic resonance imaging examinations. The pain caused by the talonavicular coalition was managed by nonoperative treatment, while the ankle pain caused by the arthritis was relieved after ankle arthroscopy. At 6 years postoperatively, the patient remained pain-free while walking for 30 minutes and was satisfied with the operative outcome. Continuous follow-up confirmed that after the formation of talonavicular coalition, the coalition can continue to progress, forming bony talocalcaneal coalition and calcaneocuboid coalition.

scholarly journals Bilateral Multiple Tarsal Coalitions (Talonavicular and Talocalcaneal Coalitions) with Recurrent Ankle Sprain in an Adolescent

Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 100
Author(s):  
Chaemoon Lim ◽  
Yong-Yeon Chu
Keyword(s):  
Differential Diagnosis ◽  
Ankle Sprain ◽  
Functional Outcomes ◽  
Rare Entity ◽  
Adolescent Patient ◽  
Ankle Pain ◽  
Tarsal Coalition ◽  
Talocalcaneal Coalition ◽  
Tarsal Bones ◽  
Recurrent Ankle Sprain

Tarsal coalition is defined as an abnormal bony, cartilaginous, or fibrous union of two or more tarsal bones. The incidence of tarsal coalition is approximately 2% in the general population. Talocalcaneal and calcaneonavicular coalitions are the most common. The talonavicular coalition is a rare entity with an incidence of approximately 1.3% among patients with tarsal coalitions. We present a case of a 12-year-old girl who had talonavicular and talocalcaneal coalitions associated with a recurrent ankle sprain. The talonavicular coalition was asymptomatic, and the talocalcaneal coalition was the cause of ankle pain and recurrent sprain. Surgical resection of the talocalcaneal coalition led to successful clinical and functional outcomes. In conclusion, the possibility of multiple tarsal coalitions should be considered in tarsal coalition patients, and the talocalcaneal coalition should be considered as a differential diagnosis in an adolescent patient with a recurrent ankle sprain.

Endoscopic Resection of Different Types of Talocalcaneal Coalition

2018 ◽  
Vol 39 (9) ◽  
pp. 1082-1088 ◽  
Author(s):  
Wael Aldahshan ◽  
Adel Hamed ◽  
Faisal Elsherief ◽  
Ashraf Mohamed Abdelaziz
Keyword(s):  
Endoscopic Resection ◽  
Nonoperative Treatment ◽  
Level Of Evidence ◽  
Vas Score ◽  
Talocalcaneal Coalition ◽  
Short Term Study ◽  
Different Types ◽  
The Mean ◽  
American Orthopaedic

Background: The purpose of this study was to describe the technique of endoscopic resection of talocalcaneal coalition (TCC) by using 2 posterior portals and to report the outcomes of endoscopic resection of different types and sites of TCC. Methods: An interventional prospective study was conducted on 20 feet in 18 consecutive patients who were diagnosed by computed tomography to have TCC for which nonoperative treatment had failed and endoscopic resection was performed. The patients were divided into groups according to the site of the coalition (middle facet or posterior facet) and according to type (fibrous, cartilage, or bony). The mean follow-up period was 26 months (range, 6-36). Results: The average preoperative American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score was 57.7 (range, 40-65), and the average preoperative visual analog scale (VAS) score was 7.8 (range, 6-8). The average postoperative AOFAS hindfoot score was 92.4 (range, 85-98; P < .01). The average postoperative VAS score was 2.4 (range, 1-4). All patients showed no recurrence on postoperative lateral and Harris-Beath X-ray until the end of the study. Conclusions: Endoscopic resection of TCC was an effective and useful method for the treatment of talocalcaneal coalition. It provided excellent outcomes with no recurrence in this short-term study. Resection of the fibrous type had a better outcome than resection of cartilage and bony types. Endoscopic resection of the posterior coalition had a better outcome than resection of the middle coalition. Level of Evidence: Level III, comparative study.

scholarly journals Surgical treatment of tarsal coalitions in children and adolescents

2020 ◽  
Vol 5 (2) ◽  
pp. 80-89
Author(s):  
Alpesh Kothari ◽  
Javier Masquijo
Keyword(s):  
Surgical Intervention ◽  
Operative Management ◽  
Foot And Ankle ◽  
Ankle Pain ◽  
Tarsal Coalition ◽  
Algorithmic Approach ◽  
Tarsal Bones ◽  
Non Operative Management ◽  
Impaired Quality

A tarsal coalition is an abnormal connection between two or more tarsal bones caused by failure of mesenchymal segmentation. The two most common tarsal coalitions are calcaneonavicular coalition (CNC) and talocalcaneal coalition (TCC). Both CNC and TCC can be associated with significant foot and ankle pain and impaired quality of life; there may also be concomitant foot and ankle deformity. Initial, non-operative management for symptomatic tarsal coalition commonly fails, leaving surgical intervention as the only recourse. The focus of this article is to critically describe the variety of methods used to surgically manage CNC and TCC. In review of the pertinent literature we highlight the ongoing treatment controversies in this field and discuss new innovations. The evidence-based algorithmic approach used by the authors in the management of tarsal coalitions is illustrated alongside some clinical pearls that should help surgeons treating this common, and at times complex, condition. Cite this article: EFORT Open Rev 2020;5:80-89. DOI: 10.1302/2058-5241.5.180106

A Solitary Rosai-Dorfman Disease of The Talus: The First Case Report of Bisphosphonate Therapy with Imaging Follow-up

2021 ◽  
Vol 104 (12) ◽  
pp. 1988-1991
Keyword(s):  
Case Report ◽  
Clinical Symptoms ◽  
Bisphosphonate Therapy ◽  
Histological Feature ◽  
Ankle Pain ◽  
First Report ◽  
Osseous Lesion ◽  
First Case ◽  
Rosai Dorfman Disease

Rosai-Dorfman disease (RDD) manifesting as a solitary osseous lesion especially of talus bone is rare. The authors reported a 31-year-old Thai man who had chronic left ankle pain and the biopsy of his talar lesion demonstrated emperipolesis, the typical histological feature of RDD. He was treated with curettage and adjuvant bisphosphonate and appeared to show improvement in clinical symptoms and radiological evidence. To the authors’ knowledge, this is the first report of an intraosseous RDD lesion treated with bisphosphonate with imaging follow-up. Keywords: Rosai-Dorfman disease; Talus; Solitary; Radiology; Bisphosphonate

scholarly journals Long-term Prognosis After Successful Nonoperative Treatment of Osteochondral Lesions of the Talus: An Observational 14-Year Follow-up Study

2020 ◽  
Vol 8 (6) ◽  
pp. 232596712092418 ◽  
Author(s):  
Lizzy Weigelt ◽  
Christoph J. Laux ◽  
Lukas Urbanschitz ◽  
Norman Espinosa ◽  
Georg Klammer ◽  
...  
Keyword(s):  
Nonoperative Treatment ◽  
Osteochondral Lesions ◽  
Ankle Pain ◽  
Ankle Osteoarthritis ◽  
Aofas Score ◽  
Sports Activity ◽  
Long Term Prognosis ◽  
Tegner Score

Background: Little is known about the long-term prognosis of osteochondral lesions of the talus (OLTs) after nonoperative treatment. Purpose: To evaluate the clinical and radiological long-term results of initially successfully treated OLTs after a minimum follow-up of 10 years. Study Design: Case series; Level of evidence, 4. Methods: Between 1998 and 2006, 48 patients (50 ankles) with OLTs were successfully treated nonoperatively. These patients were enrolled in a retrospective long-term follow-up, for which 24 patients could not be reached or were available only by telephone. A further 2 OLTs (6%) that had been treated surgically were excluded from the analysis and documented as failures of nonoperative treatment. The final study group of 22 patients (mean age at injury, 42 years; range, 10-69 years) with 24 OLTs (mean size, 1.4 cm2; range, 0.2-3.8 cm2) underwent clinical and radiological evaluation after a mean follow-up of 14 years (range, 11-20 years). Ankle pain was evaluated with a visual analog scale (VAS), ankle function with the American Orthopaedic Foot and Ankle Society (AOFAS) score, and sports activity with the Tegner score. Progression of ankle osteoarthritis was analyzed based on plain ankle radiographs at the initial presentation and the final follow-up according to the Van Dijk classification. Results: At final follow-up, the 24 cases (ie, ankles) showed a median VAS score of 0 (IQR, 0.0-2.25) and a median AOFAS score of 94.0 (IQR, 85.0-100). Pain had improved in 18 cases (75%), was unchanged in 3 cases (13%), and had increased in 3 cases (13%). The median Tegner score was 4.0 (IQR, 3.0-5.0). Persistent ankle pain had led to a decrease in sports activity in 38% of cases. At the final follow-up, 11 cases (73%) showed no progression of ankle osteoarthritis and 4 cases (27%) showed progression by 1 grade. Conclusion: Osteochondral lesions of the talus that successfully undergo an initial nonoperative treatment period have minimal symptoms in the long term, a low failure rate, and no relevant ankle osteoarthritis progression. However, a decrease in sports activity due to sports-related ankle pain was observed in more than one-third of patients.

scholarly journals The Radiographic Support for Distal Tibia Medial Opening-Wedge Osteotomy with Fibular Valgization Osteotomy for Medial Ankle Osteoarthritis

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0033
Author(s):  
Jung-Won Lim ◽  
Hong-Geun Jung
Keyword(s):  
Patient Satisfaction ◽  
Clinical Outcomes ◽  
Medial Compartment ◽  
Wedge Osteotomy ◽  
Functional Evaluation ◽  
Ankle Arthritis ◽  
Ankle Pain ◽  
Ankle Osteoarthritis ◽  
Surgical Option

Category: Ankle; Ankle Arthritis Introduction/Purpose: Supramalleolar osteotomy (SMO) has recently been accepted as the major surgical option for treating painful asymmetric ankle arthritis. The effectivenss of additional fibular valgization osteotomy during SMO procedure is still controversial. This study aimed to evaluate radiological and clinical outcomes of medial compartment ankle osteoarthritis (OA) after SMO with fibular valgization osteotomy. Also, the study is aimed to describe the radiographic support for the SMO with additional fibular osteotomy in relieving the medial ankle pain. Methods: The study is based on 45 cases of medial compartment ankle arthritis (43 patients) with moderate to severe medial ankle pain (at least 1-year follow-up). SMO and fibular valgization oblique osteotomy was performed concomitantly in 37 ankles (82.2%). As for the functional evaluation, visual analogue scale (VAS) pain scores, American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores and patient satisfaction were evaluated. On radiographs, tibial anterior surface angles (TAS), tibial lateral surface angles (TLS), and talar tilt angles (TT) were measured and the severity of ankle OA was classified by the Takakura stage. The evaluation of the effect of fibular valgization osteotomy entailed a comparison of new radiological measurement (medial clear space gap distance and talus center migaration distance) between two groups: Group 1 (with 37 cases of SMO with fibular valgization osteotomy) and Group 2 (with 8 cases of SMO without fibular valgization osteotomy). Results: The mean VAS pain score decreased from preoperative 6.5 to postoperative 1.3, and AOFAS score significantly improved from preoperative 60.4 to 88.3 at final follow-up. 91 percent (41 ankles) of the patients were satisfied with surgery. Mean TAS improved from preoperative 83.8° to postoperative 94.9° and TLS from 78.5° to 82.0°. 23 of 30 Takakura stage IIIa cases (77%) and 3 of 7 stage IIIb cases (42%) improved to stage II after SMO at final follow-up. Mean fibular valgization osteotomy angle was 12.4°. Medial gutter space gap distance improved from preoperative 0.7mm to postoperative 2.10mm. Talus center migration distance improved from -0.53mm to 2.03mm. Both radiologic parameters showed statistically significant differences between two groups, but there was no correlation between radiologic parameters and clinical outcomes. Conclusion: SMO for the patients with painful medial compartment ankle OA achieved favorable clinical and radiological outcomes. Also, high patient satisfaction (91%) as well as the improvement of Takakura stage was observed. SMO with additional fibular valgization osteotomy yielded widening of medial gutter space and recovery of talus center. Therefore, additional fibular valgization osteotomy during SMO could be optimal surgical option for the recovery of normal ankle mechanical axis.

scholarly journals Osteochondroma of talus and coalition of talocrural and intercuneiform joints - surgical management

2021 ◽  
Vol 7 (2) ◽  
pp. 420
Author(s):  
Swapnil M. Keny ◽  
Kaustubh A. Sawant ◽  
Vijay Singh ◽  
Ayush Sharma
Keyword(s):  
Ct Scan ◽  
Range Of Motion ◽  
Histopathological Examination ◽  
Full Range ◽  
Tarsal Coalition ◽  
Talocrural Joint ◽  
Tarsal Bones ◽  
One Year ◽  
Rare Benign Tumour

<p class="abstract">Osteochondroma of talus is rare benign tumour. Tarsal coalition is a condition in which two or more tarsal bones are joined by non-osseous bridges of cartilage or fibrocartilage or by osseous bridges. Association of Talus osteochondroma with coalition of tarsal bones is extremely rare and has not been reported in the literature before. We are herewith reporting a case of osteochondroma of the talus with coalition of intercuneiform and talocrural joint in an 11-year-old male patient. Patient noticed swelling around ankle and pain on strenuous activities. CT scan confirmed the diagnosis. We did complete extraperiosteal excision of the osteochondroma and resection of tarsal coalition. Histopathological examination confirmed the diagnosis of osteochondroma. At one-year follow-up there is no recurrence of the tumour and patient had full range of motion. Complete extraperiosteal excision of the osteochondroma along with resection of tarsal coalition is important for complete eradication and preventing a recurrence.</p>

Madelung Deformity: Surgical Prophylaxis (Physiolysis) During the Late Growth Period by Resection of the Dyschondrosteosis Lesion

1992 ◽  
Vol 17 (4) ◽  
pp. 401-407 ◽  
Author(s):  
D VICKERS ◽  
G. NIELSEN
Keyword(s):  
Growth Period ◽  
Late Childhood ◽  
Surgical Prophylaxis ◽  
Autologous Fat ◽  
Madelung Deformity ◽  
Late Growth

The majority of cases of Madelung deformity are caused by hereditary dyschondrosteosis at the wrist. The principal lesion in the ulnar zone of the distal radial physis retards growth asymmetrically, especially in late childhood. Resection of this zone and its replacement with autologous fat (Langenskiöld procedure, or physiolysis) restores growth and minimizes deformity. The resection of an abnormal ligament tethering the lunate proximally may assist carpal advancement. A series of 17 patients (24 wrists) treated over a 12-year period is presented, with sufficient follow-up for evaluation of 11 patients (15 wrists). The results of this prophylactic procedure are encouraging, and, if it is performed early, the authors believe that Madelung deformity may be preventable, or at least controllable.

scholarly journals Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

2019 ◽  
Author(s):  
Giovanni Luigi Di Gennaro ◽  
Stefano Stallone ◽  
Eleonora Olivotto ◽  
Paola Zarantonello ◽  
Marina Magnani ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Nonoperative Treatment ◽  
Cast Immobilization ◽  
Manipulation Under Anesthesia ◽  
Talocalcaneal Coalition ◽  
Subtalar Arthroereisis ◽  
The Mean ◽  
Retrospective Comparative Study ◽  
Graft Interposition

Abstract Background: The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods: We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis. Results: Thirty-four Children (47 feet) in the nonoperative group and twenty-one children (34 feet) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9-17). The mean follow-up averaged 6.6 (3-12) years. There were no complications in either groups. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusions: The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Keywords: tarsal coalition, talocalcaneal; flatfoot; child; surgical treatment; manipulation under anesthesia; allograft; arthroereisis.

scholarly journals Operative versus nonoperative treatment in children with painful rigid flatfoot and talocalcaneal coalition. Results from a retrospective comparative study.

2020 ◽  
Author(s):  
Giovanni Luigi Di Gennaro ◽  
Stefano Stallone ◽  
Eleonora Olivotto ◽  
Paola Zarantonello ◽  
Marina Magnani ◽  
...  
Keyword(s):  
Operative Treatment ◽  
Operative Procedure ◽  
Nonoperative Treatment ◽  
Operative Strategy ◽  
Talocalcaneal Coalition ◽  
Subtalar Arthroereisis ◽  
The Mean ◽  
Nonoperative Group ◽  
Graft Interposition

Abstract Background: The management of painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC) is controversial. We aimed to compare operative and nonoperative treatment in children with RFF and TCC. Methods: We retrospectively reviewed medical records and radiographs of children with RFF and TTC treated between 2005 and 2015. The nonoperative treatment consisted of manipulation under anesthesia, cast immobilization and shoe insert after cast removal. The operative treatment consisted of combined TCC resection, graft interposition and subtalar arthroereisis. Results: Thirty-four Children (47 feet) in the nonoperative group and twenty-one children (34 feet) in the operative group were included. No differences were found between groups, concerning baseline characteristics. The mean age at treatment was 11.8 years (9-17): 11.6 (9-17) for the nonoperative group, 12.2 (10-15) for the operative group. The mean follow-up averaged 6.6 (3-12) years and was significantly longer in the nonoperative group (7.8 versus 4.7 years; p < 0.0005), since the operative procedure was increasingly practiced in the latest years. There were no complications in either groups, but 6 patients (7 feet) in the nonoperative group were unsatisfied and required surgery. At the latest follow-up, the AOFAS-AHS improved in both groups, although the operative group showed significantly better improvement. The operative group reported also significantly better FADI score, after adjustment for follow-up and baseline variables. Conclusions: The operative treatment showed better results compared to the nonoperative treatment. Symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Further prospective randomized studies are needed to confirm our findings and to identify the best operative strategy in this condition.

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