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Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review.

Publication ,  Journal Article
Catanzano, AA; Akoh, CC; Easley, ME; Mosca, VS
Published in: JBJS Rev
June 1, 2023

» Tarsal coalitions most commonly affect the calcaneonavicular and talocalcaneal joints in up to 13% of the general population. They alter the mechanics of the subtalar joint, limiting inversion and eversion, and place excessive stress on neighboring joints causing pain, recurrent ankle sprains, and/or progressive pes planus during the adolescent growth spurt.» While many coalitions are identified on radiographs, advanced imaging with computed tomography or magnetic resonance imaging is sometimes required. These advanced imaging modalities also serve an essential role for surgical planning to quantify coalition involvement, identify fibrous or cartilaginous coalitions, and aid in determining the degree of deformity within the foot.» Surgical treatment is reserved for feet with persistent activity-related pain not relieved by prolonged attempts at nonoperative management, which include nonsteroidal anti-inflammatory drugs, shoe orthotics, and periods of non-weight-bearing in a cast. These conservative modalities may be successful in up to 85% of cases.» For adolescent patients, recent surgical options attempt to avoid arthrodesis and focus on coalition resection and interposition grafting with or without deformity correction. The ultimate decision is based on the location of the pain, the size and histology of the coalition, the health of the posterior subtalar facet, the degree of flatfoot deformity, and the presence of degenerative changes in the subtalar and/or adjacent joints.» While many studies focus on subtalar motion and gait kinematics, the critical outcomes remain pain relief and future need for arthrodesis, which may be related not only to resection of the coalition but assessment of deformity, including after the resection has been performed.

Duke Scholars

Published In

JBJS Rev

DOI

EISSN

2329-9185

Publication Date

June 1, 2023

Volume

11

Issue

6

Location

United States

Related Subject Headings

  • Young Adult
  • Tarsal Coalition
  • Pain
  • Lower Extremity
  • Humans
  • Foot
  • Flatfoot
  • Adolescent
 

Citation

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ICMJE
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Catanzano, A. A., Akoh, C. C., Easley, M. E., & Mosca, V. S. (2023). Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review. JBJS Rev, 11(6). https://doi.org/10.2106/JBJS.RVW.23.00021
Catanzano, Anthony A., Craig C. Akoh, Mark E. Easley, and Vincent S. Mosca. “Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review.JBJS Rev 11, no. 6 (June 1, 2023). https://doi.org/10.2106/JBJS.RVW.23.00021.
Catanzano AA, Akoh CC, Easley ME, Mosca VS. Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review. JBJS Rev. 2023 Jun 1;11(6).
Catanzano, Anthony A., et al. “Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review.JBJS Rev, vol. 11, no. 6, June 2023. Pubmed, doi:10.2106/JBJS.RVW.23.00021.
Catanzano AA, Akoh CC, Easley ME, Mosca VS. Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review. JBJS Rev. 2023 Jun 1;11(6).

Published In

JBJS Rev

DOI

EISSN

2329-9185

Publication Date

June 1, 2023

Volume

11

Issue

6

Location

United States

Related Subject Headings

  • Young Adult
  • Tarsal Coalition
  • Pain
  • Lower Extremity
  • Humans
  • Foot
  • Flatfoot
  • Adolescent