Non-osseous extra-articular anterolateral talocalcaneal coalition: a case report

We report a case of an extra-articular talocalcaneal coalition located anterolateral to the sinus tarsi. As non-osseous coalitions can be difficult to diagnose, physicians should keep this variant in mind in cases of a symptomatic hind foot with apparently equivocal radiological findings.     

Isolated navicular-medial cuneiform tarsal coalition revisited: a case report

Tarsal coalitions between the navicular and the cuneiforms occur infrequently when compared with the more common talocalcaneal and calcaneonavicular coalitions. Isolated cases of navicular-medial cuneiform coalitions have only rarely been reported; however, the diagnosis is likely underrecognized. Conservative management should be pursued initially for symptomatic patients, followed by surgical options for unresponsive cases. The few reports available recommend treatment with navicular-medial cuneiform fusions, but long-term follow-up is not available to assess outcome and it remains unclear whether an isolated arthrodesis of the navicular-medial cuneiform joint will in turn lead to differing biomechanics of adjacent joints. We report a case of a patient with an isolated navicular-medial cuneiform coalition, treated with resection and free-fat interposition rather than arthrodesis. To our knowledge, this is the first case of a navicular-medial cuneiform coalition reported in a patient of North American ancestry. At 2 years postoperatively, she is pain-free with all activities and has full range of motion of her ankle and subtalar joints, and full mobility at the navicular-medial cuneiform joint. This unique method provided a successful solution to this difficult situation.     

Concurrent calcaneonavicular and talocalcaneal coalitions

Dual calcaneonavicular and talocalcaneal coalitions are probably not rare. Given the possibility for failed calcaneonavicular bar resection if a concurrent talocalcaneal bar goes undetected, careful preoperative evaluation is suggested. A case presentation has been made to illustrate the clinical significance of this problem.     

Bilateral isolated tarsal navicular fracture dislocation: a case report

Fracture-dislocation of the tarsal navicular is rare injury because of strong ligamentous support on both its plantar and dorsal sides. The authors report a case of a twenty-five-year-old man who sustained bilateral isolated tarsal navicular fracture-dislocations, treated by open reduction and internal fixation combined with external fixation. The patient reported no difficulty in activities of daily living, but T1-weighted magnetic resonance imaging showed a low-intensity area in right tarsal navicular, raising suspicion of osteonecrosis when he was last seen two year three months after operation.     

Stress fracture of the talus following resection of a talocalcaneal coalition: a case report

We report the case of a 15-year-old male with bilateral talocalcaneal coalition. Following resection of the symptomatic coalition, the patient developed a painful ankle. MR imaging revealed a stress fracture of the talar body. In this report we discuss presentation and treatment of a symptomatic talocalcaneal coalition complicated by a later stress fracture as well as a review of the literature.     

Resection of talocalcaneal middle facet coalition. Interposition with a tensor fascia lata allograft: a case report.

Tensor fascia lata is utilized in the management of complex soft-tissue injuries and defects, but has not been described in the literature in the use of tissue interposition with resection of talocalcaneal middle facet coalitions. This article is a case presentation of a resection of a middle facet coalition with interposition of an allograft of tensor fascia lata. At 14 months postoperative follow-up, range of motion of the subtalar joint was noted to be 20 degrees, and without pain or crepitus. There was no radiographic evidence of degenerative changes in Chopart's joint. The patient returned to all routine and sports activities without pain. He was satisfied with the outcome of the procedure.     

C-sign and talocalcaneal coalition

Talocalcaneal coalition is an abnormal bridge between talus and calcaneus, causing pain and restriction of subtalar movement; its incidence is less than 1 %. The signs and symptoms usually become manifest in the second decade of life with ossification of the lesion. They involve flat foot, peroneal muscle spasm, tarsal tunnel syndrome, or valgus tilt of the heel. The sings need not be noticeable and may appear only as tiredness and vague pain in the hind foot after exercise or an easily twisted ankle. The authors describe the case of talocalcaneal coalition in a 20-year-old man, incidentally diagnosed at ankle fracture. The presence of C-sign led to CT examination and the exact diagnosis. Radiological demonstration of this abnormality may be difficult because plain X-ray images in both projections may show normal findings. Literature data report, in addition to C-sign, further secondary signs of talocalcaneal coalition present on lateral radiographs of the ankle joint. Although these signs do not directly point to talocalcaneal coalition, they reveal abnormal anatomy or movement of the joint and may initiate more thorough examination by CT or MRI and the establishment of an exact diagnosis. Therefore, to know the secondary signs and pay attention to them is very useful.     

Pisiforme-hamate coalition: a case report

The authors report a symptomatic case of pisiforme hamate coalition in a young woman. The resection of the synchondrosis allowed the complete resolution of the pain. The pisiforme hamate fusion is an exceptional deformity and it is confirmed by the revue of the Literature.     

Bilateral pisiform-hamate coalition causing carpal tunnel syndrome and tendon attrition. A case report

Congenital coalition of pisiform and hamate is rare and had been considered asymptomatic in the first reports. The authors report a case of bilateral pisiform-hamate coalition in a young patient, causing symptoms of median nerve compression in the carpal tunnel and attritional changes on digital flexor tendons. This type of coalition had not previously been related to such symptoms. Additionally, the morphology of the coalition on the right side is unique among published cases. Surgical treatment with bilateral excision of the coalition resulted in the resolution of symptoms.     

Bilateral tonsillolithiasis: a case report.

Although tonsilloliths are reported to be fairly common, florid cases casting distinct radiopaque shadows on panoramic radiographs are not often reported. This report illustrates such a case as an incidental finding in an asymptomatic 38-year-old female dental patient. Panoramic radiography revealed distinct radiopaque shadows over the ascending rami of the mandible bilaterally. These radiopacities were localized to the palatine tonsils by computerized tomographic inspection. Tonsillectomy was performed and tonsillolithiasis was confirmed by histopathologic examination.     

Paraarticular osteochondroma of talocalcaneal joint: a case report

An 18-year-old male presented with a swelling in the posterior aspect of the right ankle since 2 years and recent onset of pain on walking. Physical examination and Roentgenography revealed a distinct osseous lesion in the posterior aspect of the talocalcaneal joint. During surgical excision, the lesion was separate from the talus and the calcaneum and appeared to originate from the capsule of the talocalcaneal joint. Histology revealed a benign osteochondroma. The talocalcaneal joint is a very rare site for the origin of osteochondroma. From literature review, it appears that this is the first reported case of a paraarticular osteochondroma arising from the talocalcaneal joint.