Li Chunguang, Yu Guangrong
Department of Orthopaedics, Tongji Hospitial, Tongfi University, Shanghai, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2012 Jul;26(7):874-9.
To review the progress in the diagnosis and treatment of tarsal coalition.
Recent literature concerning the diagnosis and treatment of tarsal coalition was reviewed.
Tarsal coalition is a bridge between the tarsal bones of the foot. The most common types are talocalcaneal and calcaneonavicular coalitions. Calcaneonavicular coalitions can be diagnosed with an oblique radiograph of the hindfoot. Most talocalcaneal coalitions require computer tomography for diagnostic confirmation. Magnetic resonance imaging may be useful for diagnoses of cartilaginous and fibrous coalition. Casting is the usual initial treatment for the symptomatic individual. For patients with treatment failure and no degenerative changes, resection of the coalition can be performed with good results. Isolated subtalar fusion may be performed for patients with failure of talocalcaneal resections. For patients undergoing failure of subtalar fusions and calcaneonavicular resection, triple arthrodesis may be performed. During minimally invasive operation, operation indications should be strictly controlled.
The diagnosis method of tarsal coalition is clear. The clinical manifestation combined with imaging examination can improve the diagnosis rate. The surgical indication of tarsal coalition remains controversial, the randomized prospective studies are still required.
回顾跗骨联合诊断与治疗的进展。
回顾近期有关跗骨联合诊断与治疗的文献。
跗骨联合是足部跗骨之间的连接。最常见的类型是距跟和跟舟联合。跟舟联合可通过后足斜位X线片诊断。大多数距跟联合需要计算机断层扫描来确诊。磁共振成像可能有助于软骨性和纤维性联合的诊断。对于有症状的个体,通常初始治疗是石膏固定。对于治疗失败且无退变改变的患者,可进行联合切除术,效果良好。对于距跟切除失败的患者,可进行单纯距下关节融合术。对于距下关节融合和跟舟切除失败的患者,可进行三关节融合术。在微创手术过程中,手术指征应严格控制。
跗骨联合的诊断方法明确。临床表现结合影像学检查可提高诊断率。跗骨联合的手术指征仍存在争议,仍需要随机前瞻性研究。