Has anyone heard of how to treat talocalcaneal fibrocartilaginous coalition?

July 1, 2009 | By admin In New Diseases |
rare disease
yipeeitzmee

This is a very rare disease. What is the percent of a success for this surgery?

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2 Comments so far

  1. gracelyn on July 2nd, 2009

    According to this only 1/3 of cases respond to nonoperative treatment. Depending on type, symptoms might dissipate when the fibrocartilage calcifies (skeletal maturity), but may need cast immobilization. Surgery seems to be the favored option.

  2. mirror on July 5th, 2009

    Yes, it causes most spastic peroneal flat feet.
    It is the most common coalition of bones of the feet, and is not all that uncommon.

    The fibrocartilaginous part of the name just means that is the material of the bridge between bones is not ossified.

    Here is the drill:

    Children appear with symptoms, adults tend to be asymtomatic, so I assume you are talking about a child in school.

    The first step is to set goals:

    The nonsurgical treatment should be attempted first,
    since the surgical may not restore full participation in sports and physical activities.

    With that understood:

    1. relieve pain

    2. return to school and participation in all but sports activities

    3. stop all sports and physical activities (PE)

    4. return to sports activities

    5. decrease calf atrophy

    Relieve Pain-

    Nonsteroidal anti-inflamatory drugs (e.g. Ibuprofen)
    heat
    paraffin baths
    warm soaks
    whirlpool

    if pain is severe- below the knee cast x 4 to 6 weeks

    alone or combined with

    peroneal nerve block
    steroid/anesthetic injection in sinus tarsi

    When the cast is removed-

    Orthoditic devices and modified shoes
    with progressive adjustments of 1/8 to 3/8 of an inch (medial wedge)
    physical therapy
    range of motion exercises

    I am drawing this material from the podiatrist publication below.
    The podiatrist is the equivalent of an orthopedic surgeon who specializes in the hand (in this case feet), only they are a separate doctorate altogether.
    They are more highly versed on the tiny variations than an orthopedic surgeon (MD or DO), BUT, and this is a big BUT, you would do well to find one who does a great deal of this particular treatment- flatfeet.

    *****************To answer your question on success rate *******************

    30 to 90 % respond to the non-operative conservative treatment

    Most authors on the subject agree that this should be done before resorting to surgical treatment, particularly since you state the bar (coalition) to be soft rather than bone (fibrocatilaginous).

    Surgical Repair-

    You WILL correct the condition.

    But you may, as stated above, not achieve the full restoration of activities enjoyed before.

    Let this be your introduction as you educate yourself to seek specific doctors care.

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