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A 10-year-old girl complains of foot pain for the past 4 weeks while playing basketball for her school team. A radiograph is shown in Figure A. What is the most appropriate treatment?
coalition excision with fat interposition
coalition excision with extensor digitorum brevis interposition
4 weeks of immobilization in a short leg cast
excision of accessory navicular
Select Answer to see Preferred Response
A 14-year-old female presents with 6 months of bilateral foot pain at the tarsal sinus. Clinical images of standing examination and heel rise are shown in Figures A and B, respectively. Radiographs of the left foot are shown in Figure C and D. Which of the following findings most likely is associated with this patient's condition?
Dynamic supination during swing phase of gait
Limited push-off power, limited forefoot contact, and excessive heel contact during stance phase of gait
Recurrent ankle sprains
Posterior tibial tendon insufficiency
Weak tibialis anterior relative to the peroneus longus resulting in first ray plantar flexion
A 10-year-old girl has had recurrent left ankle sprains for the past 9-months. She has tried immobilization in a cast for 5-weeks which has failed to provide relief. She is tender to palpation at the tarsal sinus. Radiographs and CT scan of the left foot show an isolated calcaneonavicular coalition and physical exam revealed a neutral hind foot. What is the next best step in management?
Resection of coalition at the middle facet if <20° hindfoot valgus is present
Coalition resection and interposition of extensor digitorum brevis
Complete excision of sustentaculum tali
Resection of coalition with concomitant calcaneal neck lengthening or medial slide
A 13-year-old girl presents to the office for the first time with a history of occasional ankle sprains while playing soccer. A history reveals activity-related pain localized to the sinus tarsi. Clinical exam demonstrates pes planus without instability. A radiograph is shown in figure A. What is the most appropriate next step in treatment?
Plantar fascia repair
A 13-year-old female complains of a year long history of anterior and lateral foot and ankle pain. Physical exam demonstrates limited subtalar motion compared to her contralateral foot. A lateral radiograph is shown in Figure A. A selected CT image of the hindfoot is shown in Figure B. What foot deformity is commonly associated with this condition?
Rigid pes planus
Rocker bottom foot
A 14 year-old girl has chronic foot pain which has failed to respond to previous surgical coalition resection and soft tissue interposition. A radiograph of her foot is shown in Figure A. A CT scan demonstrates a talocalcaneal coalition with almost complete involvement of the subtalar joint. What is the treatment of choice?
revision coalition resection and extensor digitorum brevis interposition
revision coalition resection and fat interposition
The Children's Hospital of PhiladelphiaPublished on Feb 21, 2014 David Horn, MD,...
Managing the Challenging Tarsal Coalition - Dr. Mark MyersonFoot Innovate
Tarsal Coalitions: Cradle to the Grave - University of Washington Department of...