A correct evaluation of site and extension of the talocalcaneal coalition inducing biomechanical ankle alterations is very important for planning therapy. Four male patients were submitted to computed tomography (CT) and three of them were also examined by means of magnetic resonance imaging (MRI). In one patient, studied by CT only, a bilateral talocalcaneal coalition was present, while the other three patients, controlled with CT and MRI, were affected by monolateral talocalcaneal coalition which was of osseous type in one case and fibrocartilaginous in two cases. CT and MRI provided detailed information on type and extension of the coalition and both helped in distinguishing between osseous and fibrocartilaginous forms. Only MRI showed an area of subchondral ischemic disease of the posterior subtalar joint in one patient with monolateral fibrocartilaginous talocalcaneal coalition. Compared with CT, MRI proved to be more accurate in evaluation of the talocalcaneal coalition, due to its wider display capability.

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http://dx.doi.org/10.1016/0720-048x(92)90197-hDOI Listing

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Article Synopsis
  • This study evaluates the effectiveness of combining coalition resection and calcaneal lengthening osteotomy to treat symptomatic talocalcaneal coalition in children with painful flat feet.
  • An analysis of 10 pediatric patients showed significant improvements in foot deformities and pain levels, with most enjoying good postoperative outcomes after an average follow-up of 54 months.
  • The research concludes this combined surgical approach is effective, with minimal complications and no requirement for additional surgeries post-treatment.
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Tarsal coalitions in children are a group of disorders that typically present as a rigid flatfoot deformity. Operative treatment generally consists of resecting the coalition alone or resection plus flatfoot reconstructive procedures. The purpose of this study was to evaluate the rate and risk factors for complications, including infection, recurrence, and reoperation, following the surgical management of tarsal coalitions in children.

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Background: The multiplier method is an arithmetic calculation that estimates the amount of growth remaining until skeletal maturity. When predicting lower limb length discrepancy, differences in foot height are added to femur and tibia discrepancies. Foot height multipliers have not been calculated using radiographic measurements, so it is unclear whether foot height develops at the same pace as the femur and tibia.

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Objective: Many patients who undergo tarsal coalition excision have persistent postoperative pain. Most studies have utilized cat scan (CT) scan parameters of pes planovalgus and heel valgus but have found this to be an inconsistent predictor of outcomes. Plain radiographic parameters have been less utilized in trying to predict outcomes after coalition excision.

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