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Treatment of talocalcaneal coalitions.
MedLine Citation:
PMID:  22411338     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: : The purpose of this study was to review outcomes of patients treated for symptomatic talocalcaneal coalition with resection and interposition of fat graft.
METHODS: : A retrospective review was performed on all patients who underwent surgical treatment for symptomatic talocalcaneal coalition over a 13-year period. Ninety-three feet were treated with excision and fat graft interposition by 6 surgeons. All patients underwent a chart review. Patient's outcome was assessed at the last follow-up using the American Orthopaedic Foot and Ankle Society Hindfoot scale. Postoperative computed tomography scans were available for 20 feet.
RESULTS: : Forty-nine feet had follow-up of at least 12 months and had a score obtained through the American Orthopaedic Foot and Ankle Society Hindfoot scale. At an average of 42.6 months of follow-up, the average score obtained was 90/100 (excellent). The postoperative computed tomography scans demonstrated 1 recurrence (3%), which was treated with repeat excision. An additional patient was reoperated for failure to excise the coalition completely. Eleven patients (34%) underwent a subsequent surgery to correct the alignment of the foot. To the best of our knowledge, none of the patients excluded because of short follow-up had repeat surgery or recurrence.
CONCLUSIONS: : A symptomatic talocalcaneal coalition can be treated with excision and fat graft interposition, and achieve good to excellent results in 85% of patients. Patients should be counseled that a subset may require further surgery to correct malalignment.
LEVEL OF EVIDENCE: : Level IV-case series.
Authors:
George D Gantsoudes; Joanna H Roocroft; Scott J Mubarak
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  32     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  301-7     Citation Subset:  IM    
Affiliation:
*Department of Orthopedics, Riley Children's Hospital, Indiana University, Indianapolis, IN †Department of Orthopedics, Rady Children's Hospital ‡Department of Orthopedics, University of California, San Diego, CA.
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