Post-interventional Outcomes in the Management of Adult Calcaneonavicular Coalitions: A Systematic Review.

Calcaneonavicular coalitions in adults can be managed conservatively or through operative means involving resection or arthrodesis of the joints. The aim of this systematic review was to compare complication rates and functional outcomes for the different interventions. PubMed, MEDLINE, Embase, and the Cochrane Library were searched for relevant studies that reported outcomes for the management of calcaneonavicular coalitions in adults. Twenty-three studies met the inclusion criteria, comprising 118 coalitions. Forty-one coalitions were managed conservatively and 71 through operative means of which, 62 included a resection and nine had an arthrodesis performed. Patients who were operated upon had a significantly higher complication rate of 23.4% compared to 10.6% for those who were managed conservatively (p=0.048). There was no significant difference in complication rates among those who had a resection or an arthrodesis. All studies demonstrated an improvement in functional outcomes regardless of intervention used. Conservative management of calcaneonavicular coalitions in adults should continue to be advocated as first-line treatment given the lower complication rates compared to operative means.