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Outcomes of surgical management for tarsal coalitions: a systematic review

  • Orthopaedic Surgery
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Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

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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Availability of data and materials

The authors confirm that the data used in this review are openly available in databases such as MEDLINE, Central, Scopus and Web of Science.

Code availability

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Acknowledgements

The lead authors thank the corresponding authors publicly for their substantial effort leading to the final draft of the manuscript of this systematic review.

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Maksym Polt and David Alexander Graf have equally contributed to this paper and share first authorship.

Authors and Affiliations

  1. Department of Orthopedic Surgery and Traumatology, Bürgerspital Solothurn, Schöngruenstrasse 42, 4500, Solothurn, Switzerland

    Maksym Polt, David Alexander Graf, Samuel Brunner, Naeder Helmy, Timo Tondelli & Octavian Andronic

  2. Department of Trauma and Orthopaedics, Charitè University Medicine Berlin, Center for Musculoskeletal Surgery, Charitéplatz 1, 10117, Berlin, Germany

    Daniel Karczewski

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  1. Maksym Polt
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  2. David Alexander Graf
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Contributions

MP: conceptualization, project administration, investigation, methodology, writing and editing of the manuscript. DAG: conceptualization, investigation, methodology, writing and editing of the manuscript. SB: conceptualization, formal analysis. NH: supervision, formal analysis. TT: formal analysis. DK: quantitative analysis of heterogeneity. OA: conceptualization, project administration, supervision, editing of the manuscript.

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Correspondence to Maksym Polt.

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This study is a systematic review that was conducted using publicly accessible documents and therefore does not require an institutional ethics approval.

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Polt, M., Graf, D.A., Brunner, S. et al. Outcomes of surgical management for tarsal coalitions: a systematic review. Arch Orthop Trauma Surg 143, 6993–7008 (2023). https://doi.org/10.1007/s00402-023-04982-z

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  • DOI: https://doi.org/10.1007/s00402-023-04982-z

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