okoj, Volume 7, No. 7

Tarsal Coalition

Tarsal coalition is a congenital condition characterized by partial or complete fusion of two or more bones of the foot. The classic appearance of a symptomatic tarsal coalition is a rigid, flat foot, with the talocalcaneal (middle facet) and calcaneonavicular joints being the two most common sites of coalition. These typically become symptomatic in children and adolescents as the previously cartilaginous bridges begin to ossify. Although most tarsal coalitions are asymptomatic, some will result in pain, deformity, or functional limitations. Treatment should be aimed at relieving the symptoms and increasing functional ability to maintain an active lifestyle. Nonsurgical options include activity modification and resting the subtalar joint using a variety of casts, braces, and orthotics. Surgical options exist for those that remain symptomatic after conservative treatment and include resection of symptomatic coalitions or hindfoot arthrodesis (limited subtalar or triple).

    • Keywords:
    • talocalcaneal coalition

    • calcaneonavicular coalition

    • rigid pes planus

    • peroneal spastic flat foot

    • calcaneonavicular bar resection

    • talocalcaneal bar resection

    • interposition graft

    • subtalar arthrodesis

    • triple arthrodesis

    • Subspecialty:
    • Pediatric Orthopaedics

    • Foot and Ankle

Osteochondritis Dissecans of the Humeral Capitellum

Humeral capitellum osteochondritis dissecans (OCD) is a disorder of the subchondral bone and articular cartilage that can be a source of significant pain in the young athlete. Although humeral capitellum OCD can affect children of all ages, adolescent overhead-throwing athletes are particularly susceptible to developing this condition. The clinical presentation of this disorder can be quite variable: most patients present with activity-related elbow pain; however, in severe cases patients may also have mechanical symptoms. While the exact etiology of humeral capitellum OCD is unknown, repetitive microtrauma from overuse and increased valgus load across the elbow joint are thought to be causative factors. Depending on the stage of the lesion and status of the articular cartilage, several treatment options are available, including local débridement, abrasion chondroplasty, loose body removal, fragment fixation, microfracture, and osteochondral autograft transplantation procedures.

    • Keywords:
    • OCD

    • humeral capitellum OCD

    • juvenile osteochondritis dissecans

    • Little Leaguers elbow

    • Little League elbow

    • elbow OCD

    • osteochondritis dissecans of the elbow

    • Subspecialty:
    • Sports Medicine

    • Shoulder and Elbow