Talocalcaneal coalition resection and bone block subtalar joint arthrodesis

a techinical tip

  • Caleb Iehl University of Iowa, Carver College of Medicine, Iowa City, USA
  • Elijah Auch University of Iowa, Carver College of Medicine, Iowa City, USA
  • Victoria Vivtcharenko University of Iowa, Carver College of Medicine, Iowa City, USA
  • Nacime Salomão Barbachan Mansur University of Iowa, Carver College of Medicine, Iowa City, USA and Universidade Federal de São Paulo, São Paulo, SP, Brazil
  • Heather Kowalski University of Iowa, Carver College of Medicine, Iowa City, USA
  • Cesar de Cesar Netto University of Iowa, Carver College of Medicine, Iowa City, USA
Keywords: Tarsal coalition, Talocalcaneal coalition, Calcaneonavicular coalition, Cotton osteotomy, Subtalar fusion

Abstract

In this technical tip, we present the case of an obese 17-year-old female diagnosed with a severe, rigid, and symptomatic flatfoot on a background of exuberant talocalcaneal and residual calcaneonavicular coalition. Through a technical modification of the fusion resection, both coalitions were quickly and safely removed with two single cuts of an oscillating saw, resecting a medial wedge through a medial approach, without the need for “peel-off” tarsal coalition resection. To protect and guide the resection osteotomy, one Freer elevator ws inserted under direct visualization on the patent posterolateral aspect of the subtalar joint posterior facet and a second elevator was positioned underneath the talar neck. Under fluoroscopic guidance, an osteotomy was performed connecting these two points. The patient also received a bone-block subtalar joint arthrodesis and a Cotton osteotomy. Good short-term alignment correction and functional outcome were achieved. Level of Evidence V; Therapeutic Studies; Expert Opinion.

Published
30-08-2020
How to Cite
Iehl, C., Auch, E., Vivtcharenko, V., Mansur, N. S. B., Kowalski, H., & Cesar Netto, C. de. (2020). Talocalcaneal coalition resection and bone block subtalar joint arthrodesis: a techinical tip. Journal of the Foot & Ankle, 14(2), 211-218. https://doi.org/10.30795/jfootankle.2020.v14.1190