NDLI: A new classification of talocalcaneal coalitions based on computed tomography for operative planning

Content Provider	Springer Nature : BioMed Central
Author	Wang, Anhong Shi, Weili Gao, Lixiang Chen, Linxin Xie, Xing Zhao, Feng Pi, Yanbin Jiao, Chen Hu, Yuelin Jiang, Dong Guo, Qinwei
Abstract	Background Current classifications emphasize the morphology of the coalition, however, subtalar joint facets involved should also be emphasized. Objective The objective of this study was to develop a new classification system based on the articular facets involved to cover all coalitions and guide operative planning. Methods Patients were diagnosed with talocalcaneal coalition using a CT scan, between January 2009 and February 2021. The coalition was classified into four main types according to the shape and nature of the coalition: I, inferiorly overgrown talus or superiorly overgrown calcaneus; II, both talus and calcaneus overgrew; III, coalition with an accessory ossicle; IV, complete osseous coalition (I-III types are non-osseous coalition). Then each type was further divided into three subtypes according to the articular facets involved. A, the coalition involving the anterior facets; M, the coalition involving the middle facets, and P, the coalition involving the posterior facets. Interobserver reliability was measured at the main type (based on nature and shape) and subtype (articular facet involved) using weighted Kappa. Results There were 106 patients (108 ft) included in this study. Overall, 8 ft (7.5%) were classified as type I, 75 ft (69.4%) as type II, 7 ft (6.5%) as type III, and 18 ft (16.7%) as type IV. Twenty-nine coalitions (26.9%) involved the posterior facets only (subtype-P), 74 coalitions (68.5%) involved both the middle and posterior facets (subtype-MP), and five coalitions (4.6%) simultaneously involved the anterior, middle, and posterior facets (subtype-AMP). Type II-MP coalition was the most common. The value of weighted Kappa for the main type was 0.93 (95%CI 0.86–0.99) (p<0.001), and the value for the subtype was 0.78 (95%CI 0.66–0.91) (p<0.001). Conclusion A new classification system of the talocalcaneal coalition to facilitate operative planning was developed.
Related Links	https://bmcmusculoskeletdisord.biomedcentral.com/counter/pdf/10.1186/s12891-021-04567-0.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14712474
DOI	10.1186/s12891-021-04567-0
Journal	BMC Musculoskeletal Disorders
Issue Number	1
Volume Number	22
Language	English
Publisher	BioMed Central
Publisher Date	2021-08-11
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Rheumatology Sports Medicine Internal Medicine Epidemiology Talocalcaneal coalition Classification Articular facet Computed tomography
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Rheumatology
Journal Impact Factor	2.2/2023
5-Year Journal Impact Factor	2.6/2023

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