Coalition Excision and Corrective Osteotomies versus Coalition Excision and Arthroereisis in the Management of Pes Planovalgus with Talocalcaneal Coalition in Adolescents: A Randomized Controlled Trial

Abstract

Abstract Level of evidence: ΙΙ Background Talocalcaneal coalition is the most common cause of rigid flat foot in adolescents. It presents with recurrent ankle sprains, ankle pain, and foot deformity. Management is still controversial. Multiple options were utilized during the last 40 years, including arthroerisis; however, the role of arthroerisis in the management of rigid pes planovalgus remains questionable. Patients and Methods Thirty feet in 28 patients with rigid flat foot due to talocalcaneal coalition who presented to our institution between September 2018 and November 2020 were prospectively analyzed. Randomization was performed by random allocation using a computer- based system into two groups: group A for arthroereisis and coalition excision and group B for osteotomies and coalition excision. Functional and radiological outcomes and complications were recorded and analyzed using Statistical Package for Social Sciences software. Results Thirty feet in 28 patients were included in the final analysis (group A, 15 feet; group B, 15 feet). The mean age and follow-up duration of the participants were 14.5 years and 24 months, respectively. The mean AOFAS and foot and ankle ability measurement scores were 78.8±4.04 and 76.73±4.66 and 80±5 and 79±3 for groups A and B, respectively. The complication rate was higher in group A; however, this difference did not reach statistical significance. No difference was found regarding functional outcomes. Conclusion We believe that the combination of talocalcaneal coalition resection with either corrective osteotomies or arthroerisis resulted in a significant improvement of functional and radiological outcomes with no difference between both in the management of rigid pes planovalgus.