Coalition Resection and Extra-Osseous Talotarsal Stabilization for Talocalcaneal Coalition With Pes Planus Deformity: A Retrospective Study

Wenqi Gu , Xianchao Xu , Shaoling Fu , Guoxun Song , Zhongmin Shi , Hongtao Zhang

Orthopaedic Surgery ›› 2025, Vol. 17 ›› Issue (10) : 2879 -2886.

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Orthopaedic Surgery ›› 2025, Vol. 17 ›› Issue (10) : 2879 -2886. DOI: 10.1111/os.70151
CLINICAL ARTICLE

Coalition Resection and Extra-Osseous Talotarsal Stabilization for Talocalcaneal Coalition With Pes Planus Deformity: A Retrospective Study

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Abstract

Objective: The treatment of talocalcaneal coalition (TCC) with pes planus deformity in adolescent patients still presents challenges. With the pes planus deformity untreated, the final clinical outcome would be compromised. Therefore, simultaneous correction of pes planus deformity seems to be of great importance. This study aimed to retrospectively evaluate the clinical efficacy of coalition resection combined with extra-osseous talotarsal stabilization (EOTTS) treatment for adolescent TCC with pes planus deformity.

Methods: Data was reviewed for patients of TCC and pes planus deformity treated by coalition resection and EOTTS from January 2018 to January 2024. Meary's angle and talar-1st metatarsal angle (T1MA) were measured to assess the alignment improvement (paired sample t-test). Visual analog scale (VAS) for pain (Wilcoxon signed rank test) and American Orthopedic Foot & Ankle Society ankle-hindfoot score (AOFAS-AHS) (paired sample t-test) were evaluated for the overall clinical outcomes. Time to return to sports activity and complications were also recorded.

Results: No early wound or soft tissue complications occurred. At 1-year follow-up, Meary's angle and T1MA improved from 13.4° ± 5.2° to 5.1° ± 3.4°, and from 14.7° ± 3.7° to 6.4° ± 2.5°, respectively. The median VAS score decreased from 5 to 0, while the AOFAS-AHS increased from 51.1 ± 8.9 to 90.1 ± 9.3 (all p < 0.05). Fifteen patients returned to sports at a median of 3 months (range: 2–4 months). One patient experienced sinus tarsi pain, which was resolved after implant removal at 14th month postoperatively.

Conclusion: Simultaneous coalition resection and EOTTS for adolescent TCC with pes planus deformity achieves satisfactory clinical outcomes with minimal complications.

Keywords

extra-osseous talotarsal stabilization / pes planus / surgical treatment / talocalcaneal coalition

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Wenqi Gu, Xianchao Xu, Shaoling Fu, Guoxun Song, Zhongmin Shi, Hongtao Zhang. Coalition Resection and Extra-Osseous Talotarsal Stabilization for Talocalcaneal Coalition With Pes Planus Deformity: A Retrospective Study. Orthopaedic Surgery, 2025, 17(10): 2879-2886 DOI:10.1111/os.70151

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References

[1]

G. L. Di Gennaro, S. Stallone, E. Olivotto, et al., “Operative Versus Nonoperative Treatment in Children With Painful Rigid Flatfoot and Talocalcaneal Coalition,” BMC Musculoskeletal Disorders 21, no. 1 (2020): 185, https://doi.org/10.1186/s12891-020-03213-5.

[2]

B. Zhou, K. Tang, and M. Hardy, “Talocalcaneal Coalition Combined With Flatfoot in Children: Diagnosis and Treatment: A Review,” Journal of Orthopaedic Surgery and Research 9 (2014): 129, https://doi.org/10.1186/s13018-014-0129-9.

[3]

A. D. Cass and C. A. Camasta, “A Review of Tarsal Coalition and Pes Planovalgus: Clinical Examination, Diagnostic Imaging, and Surgical Planning,” Journal of Foot and Ankle Surgery 49, no. 3 (2010): 274-293, https://doi.org/10.1053/j.jfas.2010.02.003.

[4]

D. M. Stormont and H. A. Peterson, “The Relative Incidence of Tarsal Coalition,” Clinical Orthopaedics and Related Research 181 (1983): 28-36.

[5]

D. Moharamzadeh and M. De Pellegrin, “Surgical Treatment of Calcaneonavicular and Talocalcaneal Coalitions,” Foot and Ankle Clinics 26, no. 4 (2021): 873-901, https://doi.org/10.1016/j.fcl.2021.07.011.

[6]

N. M. Blitz, “Pediatric & Adolescent Flatfoot Reconstruction in Combination With Middle Facet Talocalcaneal Coalition Resection,” Clinics in Podiatric Medicine and Surgery 27, no. 1 (2010): 119-133, https://doi.org/10.1016/j.cpm.2009.08.009.

[7]

N. Gougoulias, M. O'Flaherty, and A. Sakellariou, “Taking Out the Tarsal Coalition Was Easy: But Now the Foot Is Even Flatter. What Now,” Foot and Ankle Clinics 19, no. 3 (2014): 555-568, https://doi.org/10.1016/j.fcl.2014.06.011.

[8]

H. B. Kitaoka, M. A. Wikenheiser, W. J. Shaughnessy, and K.-N. An, “Gait Abnormalities Following Resection of Talocalcaneal Coalition,” Journal of Bone and Joint Surgery. American Volume 79, no. 3 (1997): 369-374, https://doi.org/10.2106/00004623-199703000-00008.

[9]

M. Polt, D. A. Graf, S. Brunner, et al., “Outcomes of Surgical Management for Tarsal Coalitions: A Systematic Review,” Archives of Orthopaedic and Trauma Surgery 143, no. 12 (2023): 6993-7008, https://doi.org/10.1007/s00402-023-04982-z.

[10]

D. González-Martín, M. Herrera-Pérez, J. Ojeda-Jiménez, D. Rendón-Díaz, V. Valderrabano, and J. L. Pais-Brito, “Neurological Injuries After Calcaneal Osteotomies Are Underdiagnosed,” Journal of Clinical Medicine 10, no. 14 (2021): 3139, https://doi.org/10.3390/jcm10143139.

[11]

S. Greenfield and B. Cohen, “Calcaneal Osteotomies: Pearls and Pitfalls,” Foot and Ankle Clinics 22, no. 3 (2017): 563-571, https://doi.org/10.1016/j.fcl.2017.04.011.

[12]

P. J. Bresnahan, J. T. Chariton, and A. Vedpathak, “Extraosseous Talotarsal Stabilization Using HyProCure: Preliminary Clinical Outcomes of a Prospective Case Series,” Journal of Foot and Ankle Surgery 52, no. 2 (2013): 195-202, https://doi.org/10.1053/j.jfas.2012.11.013.

[13]

M. E. Graham, N. T. Jawrani, and A. Chikka, “Extraosseous Talotarsal Stabilization Using HyProCure in Adults: A 5-Year Retrospective Follow-Up,” Journal of Foot and Ankle Surgery 51, no. 1 (2012): 23-29, https://doi.org/10.1053/j.jfas.2011.10.011.

[14]

M. E. Graham, N. T. Jawrani, A. Chikka, and R. J. Rogers, “Surgical Treatment of Hyperpronation Using an Extraosseous Talotarsal Stabilization Device: Radiographic Outcomes in 70 Adult Patients,” Journal of Foot and Ankle Surgery 51, no. 5 (2012): 548-555, https://doi.org/10.1053/j.jfas.2012.05.027.

[15]

Y. Xu, X. C. Li, and X. Y. Xu, “Calcaneal Z Lengthening Osteotomy Combined With Subtalar Arthroereisis for Severe Adolescent Flexible Flatfoot Reconstruction,” Foot & Ankle International 37, no. 11 (2016): 1225-1231, https://doi.org/10.1177/1071100716658975.

[16]

A. A. Catanzano, C. C. Akoh, M. E. Easley, et al., “Decision-Making and Management of Tarsal Coalition in the Young Adult Patient: A Critical Analysis Review,” JBJS Reviews 11, no. 6 (2023), https://doi.org/10.2106/JBJS.RVW.23.00021.

[17]

L. Pino Almero, M. C. Blasco Molla, J. Navarro Muñoz, and M. F. Mínguez Rey, “Tarsal Coalitions as a Cause of Pain in the Foot of Children: Therapeutic Options,” Revista Española de Cirugía Ortopédica y Traumatología 66, no. 5 (2022): 364-370, https://doi.org/10.1016/j.recot.2021.03.007.

[18]

J. M. Schwartz, C. A. Kihm, and C. A. Camasta, “Subtalar Joint Distraction Arthrodesis to Correct Calcaneal Valgus in Pediatric Patients With Tarsal Coalition: A Case Series,” Journal of Foot and Ankle Surgery 54, no. 6 (2015): 1151-1157, https://doi.org/10.1053/j.jfas.2014.09.036.

[19]

D. Saraiva, M. Knupp, A. S. Rodrigues, T. M. Gomes, and X. M. Oliva, “Outcomes of Posterior Arthroscopic Subtalar Arthrodesis for Medial Facet Talocalcaneal Coalition,” Foot & Ankle International 42, no. 12 (2021): 1547-1553, https://doi.org/10.1177/10711007211027289.

[20]

J. Winslow, R. Norland, N. Storb, S. Cannella, and D. King, “Arthrodesis of the Subtalar Joint in a High School Football Player With a Talocalcaneal Coalition: Case Report With Functional Analysis,” Foot & Ankle Specialist 9, no. 6 (2016): 550-554, https://doi.org/10.1177/1938640016630061.

[21]

A. Saxena, R. Allen, A. Wright, F. Migliorini, and N. Maffulli, “Tarsal Coalition Resections: A Long-Term Retrospective Analysis of 97 Resections in 78 Patients,” Journal of Orthopaedic Surgery and Research 17, no. 1 (2022): 458, https://doi.org/10.1186/s13018-022-03350-8.

[22]

W. Aldahshan, A. Hamed, F. Elsherief, and A. M. Abdelaziz, “Endoscopic Resection of Different Types of Talocalcaneal Coalition,” Foot & Ankle International 39, no. 9 (2018): 1082-1088, https://doi.org/10.1177/1071100718770625.

[23]

A. Wang, L. Chen, Y. Pi, et al., “Midterm Outcomes of Talocalcaneal Coalition Arthroscopic Resection in Adults,” Foot & Ankle International 43, no. 8 (2022): 1062-1069, https://doi.org/10.1177/10711007221092756.

[24]

A. Addar, Y. Marwan, N. Algarni, G. K. Berry, and T. Benaroch, “Tarsal Coalition: Systematic Review of Arthroscopic Management,” Foot (Edinburgh, Scotland) 49 (2021): 101864, https://doi.org/10.1016/j.foot.2021.101864.

[25]

K. Malik-Tabassum, K. Wahed, C. To, L. Maling, and B. Rose, “Post-Operative Outcomes of Arthroscopic Tarsal Coalition Resection: A Systematic Review,” Journal of Orthopaedics 21 (2020): 537-543, https://doi.org/10.1016/j.jor.2020.09.014.

[26]

G. D. Gantsoudes, J. H. Roocroft, and S. J. Mubarak, “Treatment of Talocalcaneal Coalitions,” Journal of Pediatric Orthopedics 32, no. 3 (2012): 301-307, https://doi.org/10.1097/BPO.0b013e318247c76e.

[27]

S. Giannini, F. Ceccarelli, F. Vannini, et al., “Operative Treatment of Flatfoot With Talocalcaneal Coalition,” Clinical Orthopaedics and Related Research 411 (2003): 178-187, https://doi.org/10.1097/01.blo.0000069897.31220.7a.

[28]

K. J. Kernbach, N. M. Blitz, and S. M. Rush, “Bilateral Single-Stage Middle Facet Talocalcaneal Coalition Resection Combined With Flatfoot Reconstruction: A Report of 3 Cases and Review of the Literature. Investigations Involving Middle Facet Coalitions—Part 1,” Journal of Foot and Ankle Surgery 47, no. 3 (2008): 180-190, https://doi.org/10.1053/j.jfas.2008.02.005.

[29]

S. Ettinger, T. Mattinger, C. Stukenborg-Colsman, et al., “Outcomes of Evans Versus Hintermann Calcaneal Lengthening Osteotomy for Flexible Flatfoot,” Foot & Ankle International 40, no. 6 (2019): 661-671, https://doi.org/10.1177/1071100719835464.

[30]

C. Hao, Z. Li, C. Xu, et al., “Comparative Effects of Two Calcaneal Lengthening Osteotomies (Hintermann vs. Evans) in Stage II Adult-Acquired Flatfoot,” BMC Musculoskeletal Disorders 26, no. 1 (2025): 434, https://doi.org/10.1186/s12891-025-08678-w.

[31]

V. S. Mosca and W. P. Bevan, “Talocalcaneal Tarsal Coalitions and the Calcaneal Lengthening Osteotomy: The Role of Deformity Correction,” Journal of Bone and Joint Surgery. American Volume 94, no. 17 (2012): 1584-1594, https://doi.org/10.2106/JBJS.K.00926.

[32]

O. El Shazly, M. Mokhtar, N. Abdelatif, et al., “Coalition Resection and Medial Displacement Calcaneal Osteotomy for Treatment of Symptomatic Talocalcaneal Coalition: Functional and Clinical Outcome,” International Orthopaedics 38, no. 12 (2014): 2513-2517, https://doi.org/10.1007/s00264-014-2535-3.

[33]

S. Kumar and S. V. Sonanis, “Lateral Column Lengthening for Adolescent Idiopathic Pes Planovalgus Deformity - Systematic Review,” Journal of Orthopaedics 14, no. 4 (2017): 571-576, https://doi.org/10.1016/j.jor.2017.07.013.

[34]

M. E. Jara. “Evans Osteotomy Complications,” Foot and Ankle Clinics 22, no. 3 (2017): 573-585, https://doi.org/10.1016/j.fcl.2017.04.006.

[35]

C. A. Ortiz, E. Wagner, and P. Wagner, “Arthroereisis: What Have We Learned,” Foot and Ankle Clinics 23, no. 3 (2018): 415-434, https://doi.org/10.1016/j.fcl.2018.04.010.

[36]

A. Merčun, B. Kovačič, L. Suhodolčan, and M. Drobnič, “Patient Outcomes Following Extra-Osseous Talo-Tarsal Stabilization for Foot Hyperpronation,” Journal of Foot and Ankle Surgery 61, no. 2 (2022): 318-322, https://doi.org/10.1053/j.jfas.2021.09.002.

[37]

P. S. Agnew, J. D. Foster, J. Chariton, et al., “Clinical Outcomes Following Treatment of Recurrent Talotarsal Joint Dislocation Using a Type II Extraosseous Talotarsal Stabilization Implant-A Long-Term Follow-Up Study,” Journal of Foot and Ankle Surgery 62, no. 5 (2023): 877-882, https://doi.org/10.1053/j.jfas.2023.06.001.

[38]

A. Jain, G. Gupta, and A. Gupta, “Short Term Clinico-Radiological Outcome of Extra Osseous Talo-Tarsal Stabilization (EOTTS) in Flat Foot: An Indian Perspective,” Indian Journal of Orthopaedics 56, no. 1 (2021): 94-102, https://doi.org/10.1007/s43465-021-00446-x.

[39]

Ł. Kołodziej, D. Ciechanowicz, M. Wójtowicz, et al., “Prospective, Long-Term Functional Outcomes of Extra-Osseous Talotarsal Stabilization (EOTTS) Using HyProCure in Adult Patients With Talotarsal Joint Instability: Assessment of Physical Activity and Patient Satisfaction,” Journal of Clinical Medicine 12, no. 14 (2023): 4872, https://doi.org/10.3390/jcm12144872.

[40]

A. Ali Mousa, A. E. F. Howaidy, A. F. Mohamed, and M. M. Abd-Ella, “Coalition Excision and Corrective Osteotomies Versus Coalition Excision and Arthroereisis in Management of Pes Planovalgus With Talo-Calcaneal Coalition in Adolescents: A Randomized Controlled Trial,” Foot and Ankle Surgery 29, no. 6 (2023): 466-474, https://doi.org/10.1016/j.fas.2023.06.007.

[41]

J. T. Smith, M. P. Michalski, B. D. Greene, et al., “Isolated Gastrocnemius Recession for Progressive Collapsing Foot Deformity,” Journal of the American Academy of Orthopaedic Surgeons 31, no. 1 (2023): 49-56, https://doi.org/10.5435/JAAOS-D-22-00343.

[42]

R. M. Jay and N. Din, “Correcting Pediatric Flatfoot With Subtalar Arthroereisis and Gastrocnemius Recession: A Retrospective Study,” Foot & Ankle Specialist 6, no. 2 (2013): 101-107, https://doi.org/10.1177/1938640012470714.

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