Coalition resection and medial displacement calcaneal osteotomy for treatment of symptomatic talocalcaneal coalition: functional and clinical outcome.

Purpose: The purpose of this study was to evaluate the functional and clinical outcome of combined TCC resection and medial displacement calcaneal osteotomy for treatment of symptomatic talocalcaneal coalition.

Method: This is a prospective case series study on 27 patients (30 feet) who had symptomatic rigid pes planovalgus due to talocalcaneal coalition. All patients were treated by coalition resection and medial displacement calcaneal osteotomy. Pre-operative clinical and radiological assessment was done. Pain was assessed by visual analogue scale (VAS) and the functional assessment was done by the American Foot and Ankle Society score (AOFAS) for the hind foot. Pre-operative and postoperative plantar pressure assessment was done for all patients barefoot using the mat scan (Tekscan, Inc., vs. 6.34, Boston, USA).

Results: The mean follow-up period was 27.44 months (±2.47, range 23-33). Heel valgus improved from 15.03 (±6.9) degrees pre-operative to 3.09 (±2.3) degrees postoperatively. There was a statistically significant improvement in the VAS from 8.48 (±0.70) pre-operative to 3.70 (±1.13) postoperative. The mean AOFAS score showed statistically significant improvement from 39.88 (±6.09) pre-operative to 84.37 (±7.06) postoperative. There was a statistically significant decrease in mid foot pressure during standing from 48.05 kPa pre-operative to 35.30 kPa postoperative, and during walking from 148.08 kPa pre-operative to 90.22 kPa postoperative.

Conclusion: A combination of medial displacement calcaneal osteotomy with TCC resection showed statistically significant improvement in VAS and AOFAS scores, as well as decreasing the plantar pressure on the mid foot during standing and walking.