Calcaneo-Navicular Coalition in Children Diagnosis and Treatment

Abstract

Calcaneonavicular coalition (hereafter CN), is an abnormal union between the calcaneus and navicular, which may be bony (complete coalition), cartilaginous (synchondrosis, incomplete coalition) or fibrous (synfibrosis or rudimentary coalition), causing mechanical pain, which usually subside with rest. They occur mainly in the instep area. These pains can be accompanied by repeated sprains, and it is very important to emphasize that repeated sprains in children should strongly suggest the existence of a tarsal coalition, whatever its form. Symptoms most often develop during the second decade of life. Imaging examinations make it possible to diagnose the lesion, its form and its importance for the therapeutic decision. Imaging of synostosis and the CN in children is based on three examinations: standard X-rays and CTscans mainly, with magnetic resonance imaging (MRI) secondarily. Any valgus flatfoot in children should be investigated for synostosis, as in around 40% of cases, synostosis remain asymptomatic. Resection remains the mainstay of treatment, and is a straightforward procedure that regularly gives excellent results, provided that the patient's treatment plan is followed.

Keywords: Ankle, Sprains, Fibular contracture, Calcaneo-navicular coalition, Resection