Search Our Scientific Publications & Authors

Foot Ankle Clin 2022 Jun 11;27(2):327-341. Epub 2022 May 11.

OrthoCarolina Foot & Ankle Institute, 250 N Caswell Road Suite 200B, Charlotte, NC 28207, USA. Electronic address:

One of the most challenging problems facing orthopedic surgeons is persistent pain after surgery and certainly is just as frustrating following hindfoot fusion. The hindfoot joints consist of the subtalar, talonavicular, and calcaneocuboid (CC) joints. These joints are commonly fused for degenerative changes, deformity correction, inflammatory or neuropathic arthropathy, tarsal coalition, or primarily after trauma. Read More

J Pediatr Orthop 2022 Jul 10;42(6):e612-e615. Epub 2022 Mar 10.

Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, NY.

Background: The size of talocalcaneal tarsal coalitions (TCCs) is one of the main factors that is thought to influence patient outcomes after resection. Magnetic resonance imaging (MRI) is increasingly being used to diagnose and characterize TCCs. However, there is no reproducible MRI-based measurement of TCC size reported in the literature. Read More

J Child Orthop 2022 Apr 30;16(2):136-140. Epub 2022 Apr 30.

Department of Orthopaedics, Hôpital des Enfants, CHU de Toulouse, France.

Purpose: Calcaneonavicular coalition accounts for more than half of all tarsal coalitions. Resection of calcaneonavicular coalition by an open approach is the standard treatment. Treatment of calcaneonavicular coalition by an arthroscopic approach appears promising. Read More

Arthrosc Tech 2022 Apr 21;11(4):e491-e495. Epub 2022 Apr 21.

Department of Orthopaedic Surgery, Flinders University and Flinders Medical Centre, Adelaide, South Australia.

Carpal coalition is a rare condition caused by a failure in the process of apoptosis. It is often incidentally diagnosed and seldomly symptomatic. The lunotriquetral joint is the most commonly affected joint, accounting for 90% of carpal coalitions. Read More

J Am Acad Orthop Surg 2022 Apr 26. Epub 2022 Apr 26.

From the OrthoCarolina Foot and Ankle Institute, Charlotte, NC (Ford), Orthopedic Associates of Dallas, Baylor Scott & White, Dallas, TX (Zide), and the Texas Scottish Rite Hospital for Children, Dallas, TX (Zide and Riccio).

While flatfeet are normal in children, persistence into adolescence with associated pain or asymmetry warrants additional evaluation. Rigidity of a flatfoot deformity, whether a clinical report or evident on examination, should raise suspicion for pathology. The differential diagnosis includes tarsal coalition, neurogenic planovalgus, and peroneal spasticity. Read More

J Pediatr Orthop 2022 Jul 27;42(6):321-326. Epub 2022 Apr 27.

Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center-Campbell Clinic, Le Bonheur Children's Hospital.

Background: Newer cone-beam computed tomography (CT) technology has grown in popularity for evaluation of foot and ankle pathology in the weight-bearing (WB) position. Many studies have demonstrated its benefits within the adult population, but there is a paucity of its use within the pediatric literature. The purpose of this study was to describe the indications and clinical findings of WBCT within a pediatric population. Read More

J Pediatr Orthop 2022 May-Jun 01;42(5):e448-e452

Department of Orthopaedic Surgery, Stanford University, Redwood City, CA.

Background: This paper aims to report on the last 5 years of relevant research on pediatric foot and ankle pathology with specific focus on clubfoot, congenital vertical talus, toe walking, tarsal coalitions, pes planovalgus with or without accessory navicular, foot and ankle trauma, and talar dome osteochondritis dessicans.

Methods: The Browzine platform was used to review the table of contents for all papers published in the following target journals related to the treatment of pediatric foot and ankle conditions. Search results were further refined to include clinical trials and randomized controlled trials published from March 1, 2015 to November 15, 2021. Read More

Foot Ankle Surg 2022 Mar 24. Epub 2022 Mar 24.

Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; Academic Center for Evidence based Sports medicine (ACES), Amsterdam UMC, Amsterdam, The Netherlands; Amsterdam Collaboration for Health and Safety in Sports (ACHSS), International Olympic Committee (IOC) Research Center, Amsterdam UMC, Amsterdam, The Netherlands. Electronic address:

Background: The primary aim was to determine the clinical success rate after treatment for talocalcaneal (TCC) and calcaneonavicular coalitions (CNC). The secondary aim was to evaluate the complication, recurrence and revision rate.

Methods: A search was carried out in MEDLINE, EMBASE and Cochrane Library. Read More

Clin Anat 2022 Apr 6. Epub 2022 Apr 6.

Department of Radiology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.

We aimed to investigate the bone and soft tissue changes accompanying tarsal coalition (TC) and aimed to evaluate their association with the location and type of coalition. Ankle magnetic resonance imagings of 65 patients with TC were included. The relationship between the location and type of coalition and bone marrow edema, subchondral cysts, sinus tarsi syndrome, tarsal tunnel syndrome, posterior impingement syndrome, accessory bone, tibiotalar effusion, talar osteochondritis dissecans, ganglion cysts, and calcaneal spur were evaluated. Read More

Jt Dis Relat Surg 2022 28;33(1):245-248. Epub 2022 Mar 28.

Karabük Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji Anabilim Dalı, 78100 Karabük, Türkiye.

The association of accessory anterolateral talar facet (AALTF) and tarsal coalition has been reported recently. However, there is no report in the literature examining the clinical outcomes of operative treatment simultaneously addressing both AALTF and tarsal coalition. In this case series, we report the functional outcomes of operative treatment for both AALTF and calcaneonavicular coalition (CNC). Read More

Foot Ankle Surg 2022 Mar 9. Epub 2022 Mar 9.

Department of Paediatric Surgery and Orthopaedics, Jeanne de Flandre Hospital, Lille University Hospital, Lille, France. Electronic address:

Introduction: The too-long anterior process (TLAP) increases mechanical stress on the hindfoot and could lead to osteochondral lesions of the talus (OLT) by localized hyper-pressure. The purpose of this study is to investigate an association between TLAP and OLT in children.

Methods: This is a retrospective, multicenter, case-control study conducted between 2010 and 2020. Read More

Cureus 2022 Feb 18;14(2):e22358. Epub 2022 Feb 18.

Department of Orthopaedic Surgery, Government Medical College, Srinagar, Srinagar, IND.

Tarsometatarsal coalitions have rarely been reported in published literature. The few reported cases presented with varying degrees of pain. Here, we describe the case of a 16-year-old female with multiple tarsometatarsal coalitions, the first of its kind in the reported literature. Read More

J Pediatr Orthop 2022 May-Jun 01;42(5):e453-e458

Scottish Rite Hospital for Children, Dallas, TX.

Purpose: While intra-articular steroid injection has been used anecdotally in patients with symptomatic talocalcaneal coalitions recalcitrant to traditional conservative modalities, the ability of this treatment to provide symptomatic relief and obviate or delay surgical intervention remains unknown. The purpose of this study is, therefore, to assess the treatment efficacy of intra-articular subtalar steroid injection in children with symptomatic talocalcaneal coalitions.

Methods: A retrospective study of all patients with isolated subtalar coalitions was performed at a single pediatric orthopaedic institution over a 30-year period. Read More

J Foot Ankle Surg 2022 Jan 19. Epub 2022 Jan 19.

Attending Physician, Department of Orthopaedics, Kaiser Permanente, San Leandro, CA.

Hindfoot arthrodesis is often required for end-staged deformities, such as posterior tibial tendon dysfunction, osteoarthritis, or rheumatoid arthritis. Although the need for hindfoot arthrodesis is generally accepted in severe deformities, there is a debate whether a double or triple arthrodesis should be performed. The aim of our systematic review is to review the fusion rates and mean time to fusion in double and triple arthrodesis. Read More

Eur J Trauma Emerg Surg 2022 Feb 23. Epub 2022 Feb 23.

AO Research Institute Davos, Davos, Switzerland.

Purpose: Pathologies of the medial talus (e.g., fractures, tarsal coalitions) can lead to symptomatic problems such as pain and nonunion. Read More

J Can Chiropr Assoc 2021 Dec;65(3):350-359

Division of Undergraduate Education, Canadian Memorial Chiropractic College.

Objective: This study describes the radiographic diagnosis and nonoperative chiropractic management for a case of a chronic calcaneonavicular coalition in an adult patient.

Background: Calcaneonavicular coalition is a congenital/acquired condition of the tarsal bones often diagnosed in individuals 8-12 years old. Considering its rare presentation (less than 1% of the population), there remains little literature on the conservative management of this condition. Read More

Cureus 2022 Jan 7;14(1):e21003. Epub 2022 Jan 7.

Orthopaedics, Maimonides Medical Center, Brooklyn, USA.

Arthroereisis is a surgical procedure primarily used to treat flexible pes planus (flatfoot) in pediatric and young adult patients. The principal goal of subtalar arthroereisis is to relieve pain and restore function. This is primarily done by restoring the medial foot arch without fusing the subtalar joint and without requiring a long recovery period needed after osteotomies. Read More

Children (Basel) 2022 Jan 12;9(1). Epub 2022 Jan 12.

Department of Orthopedic Surgery, Jeju National University Hospital, Jeju 63241, Korea.

Tarsal coalition is defined as an abnormal bony, cartilaginous, or fibrous union of two or more tarsal bones. The incidence of tarsal coalition is approximately 2% in the general population. Talocalcaneal and calcaneonavicular coalitions are the most common. Read More

J Foot Ankle Surg 2021 Dec 18. Epub 2021 Dec 18.

Director of Residency Training, Division of Foot and Ankle Surgery, West Penn Hospital, Allegheny Health Network, Pittsburgh, PA. Electronic address:

Subtalar joint (STJ) arthrodesis is a well-established and accepted surgical procedure utilized for the treatment of various hindfoot conditions including primary or posttraumatic subtalar osteoarthritis, hindfoot valgus deformity, hindfoot varus deformity, complex acute calcaneal fracture, symptomatic residual congenital deformity, tarsal coalition, and other conditions causing pain and deformity about the hindfoot. Union rates associated with isolated subtalar joint arthrodesis are generally thought to be favorable, though reports have varied significantly, with non-union rates ranging from 0 to 46%. Various fixation constructs have been recommended for STJ arthrodesis. Read More

Iowa Orthop J 2021 12;41(2):6-11

Department of Orthopedics, Aalborg University Hospital, Aalborg, Denmark.

Background: Patient Reported Outcome Measures (PROM) after resection of tarsal coalitions are sparse. This cross-sectional study evaluates the outcome after resection of tarsal coalitions in children using the validated Oxford Foot and Ankle Questionnaire (OxAFQ).

Methods: Tarsal coalition patients between 5-16 years of age from Aarhus University Hospital (Denmark) and The Royal London Hospital (United Kingdom) were included. Read More

Br J Radiol 2022 Apr 5;95(1132):20210784. Epub 2022 Jan 5.

Department of Radiology, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, UK.

Objective: To determine the additional benefit of MRI for children with flatfoot deformity assessed with weight-bearing radiographs in a specialist paediatric orthopaedic unit.

Methods And Materials: Patient cohort was obtained by searching the Radiology Information System for children referred for investigation of flatfoot. All patients with flatfoot on weight-bearing radiographs who had undergone MRI were included. Read More

Curr Opin Pediatr 2022 02;34(1):100-106

Division of Pediatric Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA.

Purpose Of Review: Acute ankle sprains frequently occur in active children and adolescents but may be the initial clinical presentation of other less common disorders affecting the lower extremities. There are many conditions that may cause one or multiple episodes of ankle injury that are misdiagnosed as an acute ankle sprain. This manuscript highlights diagnoses that should be considered when evaluating and managing a child or adolescent who presents initially and/or repeatedly with an acute ankle sprain. Read More

Clin Podiatr Med Surg 2022 Jan;39(1):129-142

Department of Surgery, Cambridge Health Alliance, Harvard Medical School, 1493 Cambridge Street, Cambridge, MA 02139, USA.

Tarsal coalitions are recognized as a congenital anomaly whereby the two or more bones of the hindfoot and midfoot are fused resulting in limitation of foot motion and pain. Tarsal coalitions were found to be the cause of painful flatfeet in adolescents and young adults. Developing a clinical understanding of tarsal coalitions as well as developing a step-wise conservative and surgical approach for their treatment can alleviate patient symptomatology and provide excellent long-term benefits. Read More

Foot Ankle Clin 2021 Dec 30;26(4):941-954. Epub 2021 Aug 30.

Department of Orthopaedic Surgery, University of Colorado, Denver, CO, USA.

Complex tarsal coalition includes extensive talocalcaneal coalition, double or triple coalition, coalition with severe hindfoot deformities, or coalition with a ball-and-socket ankle deformity. Careful preoperative physical examination including diagnostic injection is important in treatment planning. Both radiographic examination and computed tomographic scan that involve not only the foot but also the ankle are necessary to analyze the location and size of the coalitions, determining the presence of arthritis in the involved or adjacent joints, and if there are any deformities including a ball-and-socket ankle, which is frequently associated with complex tarsal coalitions. Read More

Foot Ankle Clin 2021 Dec 4;26(4):873-901. Epub 2021 Oct 4.

Head Pediatric Orthopedic and Traumatology Unit, San Raffaele Hospital, Via Olgettina 60, Milan 20132, Italy. Electronic address:

Tarsal coalition is determined by an absence of segmentation between one or more foot bones. The main symptom is activity-related foot pain, usually dorsolateral for calcaneonavicular coalitions and medial for talocalcaneal ones. At presentation, a symptomatic tarsal coalition must be treated conservatively for at least 6 months. Read More

JBJS Case Connect 2021 10 27;11(4). Epub 2021 Oct 27.

Department of Orthopaedics, Rutgers New Jersey Medical School, New Jersey.

Case: Tarsal-carpal coalition syndrome (TCCS) is a disorder identified by fusion of the carpals, tarsals, and phalanges of the hands and feet. We describe a case of an 11-year-old girl who has been followed at our outpatient clinic from the age of 8 months.

Conclusion: Although patients with TCCS can experience a wide range of symptoms, the primary complaint arises from the foot deformity and associated pain. Read More

Skeletal Radiol 2022 Jun 13;51(6):1115-1125. Epub 2021 Oct 13.

University of Missouri, Hospital Drive, Columbia, MO, 65212, USA.

The purpose of this article is to focus attention on the abnormalities which the radiologist may encounter in patients presenting with lateral ankle or foot pain outside of the context of acute trauma. These include anterolateral impingement, subfibular impingement, subtalar instability and tarsal sinus syndrome, tarsal coalition, sural neuromas, peroneal tendon abnormalities, calcaneocuboid instability and occult cuboid fractures, and painful accessory ossicles. The expected and unexpected findings on radiographs, CT, US, and MRI are discussed. Read More

Yeungnam Univ J Med 2021 Oct 5. Epub 2021 Oct 5.

Department of Physical Medicine and Rehabilitation, Yeungnam University College of Medicine, Daegu, Korea.

Foot (Edinb) 2021 Dec 22;49:101864. Epub 2021 Sep 22.

Division of Orthopaedic Surgery, McGill University Health Centre, Montreal, Quebec, Canada.

Introduction: The standard of care in the treatment of symptomatic tarsal coalitions is open surgery. However, certain limitations exist with open surgery, which include limited visualization leading to an incomplete resection and possible recurrence of the tarsal coalition. Arthroscopic tarsal coalition resection (TCR) is an alternative that is gaining traction, primarily as the safety profile of posterior ankle and subtalar arthroscopy is more well understood. Read More

Genes (Basel) 2021 08 29;12(9). Epub 2021 Aug 29.

Ingham Institute, School of Psychiatry, University of NSW, Sydney, NSW 2170, Australia.

Multiple synostoses syndrome type 4 (SYNS4; MIM 617898) is an autosomal dominant disorder characterized by carpal-tarsal coalition and otosclerosis-associated hearing loss. SYSN4 has been associated with GDF6 gain-of-function mutations. Here we report a five-generation SYNS4 family with a reduction in expression resulting from a chromosomal breakpoint 3' of . Read More