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Tarsal Coalition
Published in Benjamin Joseph, Selvadurai Nayagam, Randall T Loder, Anjali Benjamin Daniel, Essential Paediatric Orthopaedic Decision Making, 2022
She walked with an antalgic gait. The medial longitudinal arch was lower on the leftside than on the right. When she stood on tip toes, her leftheel did not swing into varus, and the arch did not get restored as much as on the right (Figure 42.1a). The gastroc-soleus was mildly tight, and passive motion of the subtalar joint was reduced. Tenderness was elicited just anterior to the lateral malleolus. Rapid inversion of the forefoot produced pain and demonstrable spasm of the peroneal muscles (Figure 42.1b). A provisional diagnosis of a tarsal coalition was made.
Examination of Foot and Ankle in a Child
Published in Nirmal Raj Gopinathan, Clinical Orthopedic Examination of a Child, 2021
Nirmal Raj Gopinathan, Mandeep Singh Dhillon, Pratik M. Rathod
A child with a frequent giving way of the ankle or repeated ankle sprains may have chronic ankle instability. Remember to rule out a tarsal coalition in the absence of clinically demonstratable instability. The two structures requiring assessment are the ATFL and the CFL (calcaneao-fibular ligament). The integrity of the ATFL is assessed using the anterior drawer test, and the integrity of the CFL is assessed using the talar tilt test with the findings compared with the contralateral normal side.
Paediatric and adolescent foot disorders
Published in Maneesh Bhatia, Essentials of Foot and Ankle Surgery, 2021
Tarsal coalition is an abnormal connection between two or more tarsal bones. The majority are congenital resulting from mesenchymal segmentation failure during fetal development of the tarsal bones. An autosomal dominant inheritance pattern with a high penetrance has been suggested (89–94). The bridging may be fibrous (syndesmosis), cartilaginous (synchondrosis), or osseous (synostosis). It is generally estimated to affect 1–2% of the population; however, recent radiological and cadaveric studies described an incidence of up to 13%. Coalitions are bilateral in approximately 50% of cases with no sex predilection. The talocalcaneal coalition (TCC), primarily at the middle facet, and the calcaneonavicular coalition (CNC), between the anterior process of the calcaneus and the navicular, equally account for more than 90% of all cases. It can occur infrequently in any other 2 adjacent bones of the foot (95–100).
Proximal interphalangeal-level fracture in patient with symphalangism
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
Tommy Pan, Don Hoang, Alexander Payatakes
Symphalangism is often associated with other skeletal abnormalities such as camptodactyly, clinodactyly, syndactyly, radiohumeral fusion, pes planus, bilateral hip dislocation, tarsal coalition, and congenital fusion of the cervical or thoracic spine [10]. The fused phalanges result in diminished hand function with inability to make a fist and difficulty performing fine movements. Associated findings may include absence of cutaneous creases over the affected joints and conductive hearing loss [8].