[Surgical treatment of talocalcaneal coalition].

OBJECTIVE: To explore the operative method and effectiveness of talocalcaneal coalition.

METHODS: Between July 2008 and October 2010, 10 patients with talocalcaneal coalition were treated, including 2 cases of congenital talocalcaneal coalition and 8 cases of secondary talocalcaneal coalition. There were 4 males and 6 females, aged 53.5 years on average (range, 16-70 years). Three patients had middle-facet talocalcaneal coalition and 7 had posterior-facet talocalcaneal coalition. The preoperative visual analogue score (VAS) was 9.0 +/- 0.4. According to American Orthopedic Foot and Ankle Society (AOFAS) hindfoot scale, the score was 42.4 +/- 1.4. Two cases complicated by subtalar degeneration. Resection of the bone bar and fat packing were performed in 8 cases of simple talocalcaneal coalition, and resection and subtalar arthrodesis in 2 cases of talocalcaneal coalition combined with subtalar degeneration.

RESULTS: Primary healing of incisions was obtained in all patients. Eight patients were followed up 18 months on average (range, 12-36 months). At last follow-up, VAS was 2.0 +/- 0.7, showing siginificant difference when compared with preoperative score (t = 6.425, P = 0.000). AOFAS score was 86.9 +/- 2.3, showing significant difference when compared with preoperative score (t = 7.634, P = 0.000). The X-ray films showed that no recurrence of talocalcaneal coalition was observed in patients underdoing simple removal of bone bar, and bone fusion was observed in patients undergoing arthrodesis.

CONCLUSION: To achieve satisfactory outcomes for talocalcaneal coalition, a reasonable surgical procedure should be chosen according to the specific facet and complication.