Management of Pes Planovalgus With Talocalcaneal Coalition ,Osteotomy vs Arthroereisis

Study Overview
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Brief Summary
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the investigators compare the corrective osteotomies vs arthroereisis in management of talcalcaneal coalition in adolescents as regard the outcome to provide the best intervention for the patient

Detailed Description
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In talocalcaneal coalition management is controversial so in this study the invstigators try to compare techniques other than coalition excision only or fusion only by using two types of intervention including first coalition excision and multiple corrective osteotomies according to deformity as evans ,medial displacement calcaneal osteotomy and cotton osteotomy vs coalition excision and arthroereisis the investigators compare functional and radiological outcomes and complication to provide the best management for these patients .

Official Title
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Coalition Excision and Corrective Osteotomies vs Coalition Excision and Arthroereisis in Management of Pes Planovalgus With Talocalcaneal Coalition in Adolescent

Conditions
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Talocalcaneal Bar, Pes Planus

Intervention / Treatment
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* Procedure: Coaltion excision and arthroereisis
* Procedure: Coalition excision and corrective osteotomies


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: flat foot due to talocalcaneal coalition Symptomatic patient Resectable coalition Age between 10 and 20 Exclusion Criteria: flat foot of other etiology Age more than 20 Concurrent knee deformity unless corrected before surgery Extensive coalition more than 50 %of posterior facet

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: 2 groups one with the first intervention arthroereisis and bar excision the second with bar excision and osteotomies it may be one or multiple
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: coalition excision and arthroereisis<br>Talocalcaneal bar excision is done and then arthroereisis implant is applied in subtalar joint to correct rigid pes planovalgus in adolescent | Procedure: Coaltion excision and arthroereisis<br>* Both done to treat rigid flat foot with talocalcaneal coalition. Talocalcaneal coalition excision and management of rigid pes planovalgus in adolescent<br>* Other names: Coalition excision and corrective osteotomies;|
| Experimental: coalition excision and corrective osteotomies<br>Talocalcaneal bar excision is done and then according to degree of deformity either medial displacement calcaneal osteotomy or evans or cotton osteotomy is done or combined together to correct rigid pes planovalgus in adolescents | Procedure: Coalition excision and corrective osteotomies<br>* Both done to treat rigid flat foot with talocalcaneal coalition. Talocalcaneal coalition excision and management of rigid pes planovalgus in adolescent<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Degree of deformity valgus | By goniometer | preoperative | 
| Degree of deformity valgus | By goniometer | three months | 
| Degree of deformity valgus | By goniometer | six months | 
| Degree of deformity valgus | By goniometer | one year postoperative | 
| Degree of deformity valgus | By goniometer | two year postoperative | 
| Subtalar range of motion | By geniometer for inversion and eversion | preoperative | 
| Subtalar range of motion | By geniometer for inversion and eversion | three months | 
| Subtalar range of motion | By geniometer for inversion and eversion | six months | 
| Subtalar range of motion | By geniometer for inversion and eversion | one year postoperative | 
| Subtalar range of motion | By geniometer for inversion and eversion | two year postoperative | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| functional outcome | By foot ankle ability measurement score | preoperative | 
| Patient satisfaction | By foot and ankle disability score | preoperative | 
| functional outcome | By foot ankle ability measurement score | three months | 
| Patient satisfaction | By foot and ankle disability score | three months | 
| functional outcome | By foot ankle ability measurement score | six months | 
| Patient satisfaction | By foot and ankle disability score | six months | 
| functional outcome | By foot ankle ability measurement score | one year | 
| functional outcome | By foot ankle ability measurement score | two year | 
| Patient satisfaction | By foot and ankle disability score | one year | 
| Patient satisfaction | By foot and ankle disability score | two year |