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Titre : | Surgical Treatment of Calcaneonavicular and Talocalcaneal Coalitions : Foot Ankle Deformity in the Child (2021) |
Auteurs : | Désirée Moharamzadeh ; Maurizio De Pellegrin |
Type de document : | Article |
Dans : | Foot and Ankle Clinics (Vol. 26, n° 4, December 2021) |
Article en page(s) : | p. 873-901 |
Note générale : | https://doi.org/10.1016/j.fcl.2021.07.011 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Chirurgie générale ; Coalition tarsienne ; Imagerie diagnostique ; Os du métatarse ; Synostose ; Traitement conservateur |
Résumé : |
Calcaneonavicular (CNC) and talocalcaneal (TCC) coalitions are the most common causes of rigid flatfoot (RFF) in children. Resection with interposition of fat graft is the treatment of choice in symptomatic flatfeet.
Plan radiographs are not always able to reveal the presence of CNC and TCC. Computed tomography (CT) is a useful tool for assessment, particularly of TCC, while MRI plays an important role in painful RFF with a suspected fibrous or cartilaginous CNC and/or TCC coalition; CT technique should be performed perpendicular to the subtalar joint (coalition-specific axial plane) to permit a better visualization of the facets and with 1.0 × 1.0-mm slices. CT scan 3D reconstruction is useful for surgical planning. MRI can detect earlier the presence of a painful non-ossified coalition allowing an early resection of the fibrous or cartilaginous tissue before a complete osseous or rigid deformity develops. After resection, the correction of the most frequent hindfoot valgus deformity usually requires further surgery, such as lateral column lengthening. Arthrodesis is the most common surgical procedure for symptomatic flatfeet in adulthood. Adult patients with untreated coalitions or residual valgus deformity of the hindfoot often complain of anterolateral pain due to the calcaneofibular impingement and/or arthritis and medial pain around the osseous coalition. MRI can show bone marrow edema in the coalition area and in other areas of the affected foot, explaining symptoms and aiding in surgical indications, even in osseous coalitions. Subtalar arthroereisis for correction of residual hindfoot valgus can be performed after resection in one step. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S1083751521000917 |