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

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.