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Archives of Orthopaedic and Trauma Surgery

Erschienen in:

18.07.2023 | Orthopaedic Surgery

Outcomes of surgical management for tarsal coalitions: a systematic review

verfasst von: Maksym Polt, David Alexander Graf, Samuel Brunner, Naeder Helmy, Timo Tondelli, Daniel Karczewski, Octavian Andronic

Erschienen in: Archives of Orthopaedic and Trauma Surgery | Ausgabe 12/2023

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Abstract

Purpose

To analyze the outcome of surgical treatment of tarsal coalition, assess the role of the surgical technique, as well as of coalition size and type on outcomes.

Methods

The search followed the Preferred Reporting Items of Systematic Review and Meta-Analysis and was performed in four databases: MEDLINE, Central, Scopus and Web of Science. The protocol has been registered in the international prospective register of systematic reviews. Patient-reported outcomes (PROMs), complications, revisions and radiographic recurrence were collected. Risk of bias was assessed using MINORS criteria. A random-effects model for meta-analysis was applied for analysis of data heterogeneity.

Results

Twenty-five studies including 760 tarsal coalitions were included and had a weighted average follow-up of 44 months. Studies scored fair to poor on the risk of bias assessment with a mean MINORS score of 67% (44–81%). In 77.8% (37.5–100%) of surgically treated tarsal coalitions, good/excellent/non-limiting or improved PROMs were reported. Calculated data heterogeneity was moderate (I² = 57%). Open bar resection with material interposition had a clinical success rate of 78.8% (50–100%). Complications occurred in 4.96% of cases. Coalition size did not prove to be a determining factor in postoperative outcome. The influence of the coalition type was not investigated by any of the studies.

Conclusion

Data on outcomes of surgical management for tarsal coalitions is limited to retrospective case series with high risk of bias and moderate data heterogeneity. In about ¾ of cases, open resection and interposition of material results in improved PROMs. The arbitrary margin of ≥ 50% of TC coalition size in relation to the posterior facet has little importance in surgical decision-making. None of the studies reported on the influence of the coalition type on postoperative clinical success.

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Titel: Outcomes of surgical management for tarsal coalitions: a systematic review
verfasst von: Maksym Polt
David Alexander Graf
Samuel Brunner
Naeder Helmy
Timo Tondelli
Daniel Karczewski
Octavian Andronic
Publikationsdatum: 18.07.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Archives of Orthopaedic and Trauma Surgery / Ausgabe 12/2023
Print ISSN: 0936-8051
Elektronische ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-023-04982-z

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Outcomes of surgical management for tarsal coalitions: a systematic review