Percutaneous resection of calcaneo-navicular coalition with interposition of synthetic graft

BackgroundSurgical resection of calcaneo-navicular coalition (CNC) with interposition of fat or muscle graft is indicated when there is failure of conservative treatment.Objectivesto evaluate the clinical and functional of outcome of a new mini-invasive technique for resection of CNC and interposition of synthetic graft.MethodsThis is a prospective case series study on 9 patients (12 feet) with symptomatic CNC. Percutaneous resection of the CNC was done using a motorized bone burr through a small incision in the sinus tarsi under image intensifier control. After complete resection a synthetic graft of Teflon or Dacron measuring 15 mm × 30 mm was interposed to prevent re-union of the bone bar.ResultsThe mean follow up period was 26.44 months (±1.5 SD). There was statistically significant improvement in the mean total AOFAS score from 47.89 (±8.49 SD) preoperatively to 90.22 (± 5.26 SD) at two years follow up (P < 0.05). The mean time to return to full daily activity was 7.44 weeks (±0.88 SD)ConclusionPercutaneous resection of calcaneo-navicular bar with interposition of synthetic graft is an effective mini-invasive method for treatment of calcaneo-navicular coalition with good results in 44.4% of patients and excellent results in 55.6% of patients.