Description
In this detailed presentation, Helen Chase, a pediatric orthopedic surgeon, discusses the complex topic of tarsal coalition, primarily focusing on pediatric and young adult cases. The talk starts by explaining the pathology involved in tarsal coalition, which occurs when bones in the foot fail to segment properly due to mesenchymal cell failure, leading to the fusion of tarsal bones—predominantly seen in the calcaneonavicular and talocalcaneal joints. She highlights the genetic aspects, common presentations in children aged 8-12, and the importance of identifying the condition through clinical observation and imaging.
Chase discusses the diagnosis intricacies, including signs visible on X-rays, and emphasizes conservative treatment methods such as physiotherapy, insoles, and casting before considering surgical options. She details the surgical approaches, particularly the Ollier's technique for resecting coalitions, the use of grafts, and the nuances of addressing complications like recurrent flatfoot post-surgery.
The presentation culminates in a discussion on the evolving surgical techniques, including augmented reality and CT-specific cutting blocks that enhance precision in tarsal coalition resections. She concludes with key takeaways on prioritizing conservative management and careful pre-operative planning, underlining the need for individualized approaches based on patient assessment.