This 1998 narrative review by Vincent covers the diagnosis and management of tarsal coalition as a cause of painful flatfoot in pediatric patients, addressing prevalence, heredity, radiologic workup, biomechanics of subtalar restriction, and surgical decision-making for calcaneonavicular and talocalcaneal coalition subtypes.
When an adolescent presents with painful flatfoot and restricted subtalar inversion, work up for tarsal coalition: oblique radiograph first for calcaneonavicular bar, then CT if talocalcaneal coalition is suspected.
If conservative management (cast × 2–4 weeks, then UCBL orthosis) fails, excision with soft-tissue interposition is the primary surgical option — extensor digitorum brevis for calcaneonavicular, fat graft for talocalcaneal. Reserving triple arthrodesis for advanced degeneration or salvage.
This 1998 narrative review by Vincent covers the diagnosis and management of tarsal coalition as a cause of painful flatfoot in pediatric patients, addressing prevalence, heredity, radiologic workup, biomechanics of subtalar restriction, and surgical decision-making for calcaneonavicular and talocalcaneal coalition subtypes.
When an adolescent presents with painful flatfoot and restricted subtalar inversion, work up for tarsal coalition: oblique radiograph first for calcaneonavicular bar, then CT if talocalcaneal coalition is suspected.
If conservative management (cast × 2–4 weeks, then UCBL orthosis) fails, excision with soft-tissue interposition is the primary surgical option — extensor digitorum brevis for calcaneonavicular, fat graft for talocalcaneal. Reserving triple arthrodesis for advanced degeneration or salvage.