RESECTION FOR SYMPTOMATIC TARSAL COALITION – LONG TERM RESULTS

Purpose: The current study assessed the post-operative long-term outcome of up to 9 years follow-up of tarsal coalition treated with resection, utilizing the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score. To the best of our knowledge this is the first study utilizing that score in regard to Tarsal coalition resection as a sole treatment. Materials and Methods : Between 1988 and 1999, 36 patients (36 feet) with painful flatfoot and restricted range of motion attributable to talocalcaneal and calcaneonavicular coalition were treated with resection of the coalition in multiple medical centers in Israel. Thirty-one patients were male and five female. Twentyfive patients had unilateral coalition and eleven patients had bilateral coalition. Coalition types were talocalcaneal(29) and calcaneonavicular(7). The patients were interviewed and examined during a follow-up period of 12 to 108 months, with an average of 51.6 months. Results: Outcome was based on the ankle hindfoot clinical rating system of the American Orthopaedic Foot and Ankle Society. The clinical results were also evaluated statistically. Favorable outcome was evident in only 50% of cases. Average score was 79.2 in talocalcaneal coalition patients and 85.4 in calcaneonavicular coalition patients (not statistically significant). A multivariate statistical analysis was done and an equation was found, which elucidates the connection between age, gender and diagnosis, and AOFAS score. Conclusions: On the basis of these results, three parameters were found to affect the operative outcome: age, type of coalition and gender. Age itself stands alone as a predictive tool to the postoperative outcome. The equation that was found to correlate age, type of coalition and gender with the score can act as a predictive tool of the outcome and aid in preoperative patient selection for tarsal coalition resection.