Patient-reported Outcomes of Calcaneonavicular Coalitions Treated With Surgical Excision and Fat Graft Interposition: A Two-Center Experience
Abstract
Background: The purpose of the present study was to evaluate clinical/radiographic outcomes, and complications for calcaneonavicular coalition (CNC) excision and fat graft interposition in patients under the age of 18. Materials and Methods: A retrospective review of all pediatric patients surgically treated with symptomatic CNC at two institutions was performed. Demographic data and postoperative complications were recorded. Functional results were evaluated with AOFAS Ankle-hindfoot Scale and Visual Analog Scale (VAS). Radiographic assessment of coalition recurrence was performed on the most recent oblique radiograph (resected gap remaining <50%). Results: Between January 2008 and January 2018, 52 patients (65 feet) with CNC were surgically treated. Forty patients (48 feet) met the inclusion criteria and were available for evaluation. The average age at surgery was 11.9 years old (range 9-17 years old). The average follow-up was 43 months. The average AOFAS score improved from 58.9±8 points preoperative to 92.9±7.8 points postoperatively (p<0.001). Preoperative pain scores averaged 6.9 ± 2.5 points. At the last follow-up, the VAS score was 0.49 ±1.1 points (p<0.001). Most patients (87.5%) were painless at the last follow-up and five patients (6 feet) had occasional pain with strenuous activities. Five complications were recorded: wound dehiscence (N=3) and superficial infection (N=2). Two feet (4.2%) had coalition regrowth on the postoperative radiographs without requiring further surgery. Conclusion: Calcaneonavicular coalition excision with fat graft interposition can improve function and relieve pain with a low rate of complications in the pediatric-adolescent population.Downloads
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