Surgical management of symptomatic talocalcaneal coalitions by resection of the sustentaculum tali.

Previously described techniques for surgical resection of the subtalar coalitions are technically demanding, with poor outcomes related to incomplete resection and recurrence of the coalition. A new technique, involving complete excision of the involved portion of the sustentaculum tali, has been developed at the authors' institution. A retrospective review of 10 patients with 12 coalitions was performed. The index procedure was performed at an average age of 12.7 years, with a mean follow-up of 5.1 years. Preoperative CT scans obtained to assess the extent of the coalition were analyzed. The AOFAS Hindfoot Questionnaire was used postoperatively to assess the patients' overall outcome and satisfaction with the procedure. Overall, there were eight excellent results and three good results. The postoperative mean AOFAS score was 90 compared with a preoperative score of 46. There have been no recurrences of the coalition or progressive foot malalignment in this series of patients.