Abstract：
BACKGROUND: The primary aim was to determine the clinical success rate after treatment for talocalcaneal (TCC) and calcaneonavicular coalitions (CNC). The secondary aim was to evaluate the complication, recurrence and revision rate.
METHODS: A search was carried out in MEDLINE, EMBASE and Cochrane Library. Methodological quality was assessed using the Methodological Index for Non-Randomised Studies (MINORS) criteria. The primary outcome was the clinical success rate and was pooled per type of coalition and treatment modality. 95% Confidence Intervals (CI) of the success rates were calculated. Secondary outcomes included complication rates, coalition recurrence rates, revision rates and pain improvement using the Visual Analogue Scale (VAS). A sub-analysis on interposition material was performed.
RESULTS: 43 articles comprising of 1284 coalitions were included, with a pooled mean follow-up of 51 months. Methodological quality was fair. The overall pooled success rate for TCCs was 79% (95% CI, 75%-83%). Conservative treatment, open resection and arthroscopic resection of TCCs resulted in success rates of 58% (95% CI, 42%-73%), 80% (95% CI, 76%-84%) and 86% (95% CI, 71%-94%), respectively. CNCs have an overall success rate of 81% (95% CI, 75%-85%), with 100% (95% CI, 34%-100%), 80% (95% CI, 74%-85%) and 100% (95% CI, 65%-100%) for conservative treatment, open resection and arthroscopic resection, respectively. Pooled complication rates of 4% (95% CI, 3%-7%) for TCCs and 6% (95% CI, 4%-11%) for CNCs were found. The success rates of resection with and without interposition material for TCCs were 83% (95% CI, 78%-87%) and 79% (95% CI, 65%-88%), and for CNCs 81% (95% CI, 76%-86%) and 69% (95% CI, 44%-85%), respectively.
CONCLUSIONS: Treatment of tarsal coalitions can be considered good to excellent as well as safe, with an overall clinical success rate of 79% for TCCs and 81% for CNCs. Arthroscopic resection of the coalition appears to be non-inferior to open resection of TCCs and CNCs.
METHODS: Level IV, Systematic Review.
METHODS: A search was carried out in MEDLINE, EMBASE and Cochrane Library. Methodological quality was assessed using the Methodological Index for Non-Randomised Studies (MINORS) criteria. The primary outcome was the clinical success rate and was pooled per type of coalition and treatment modality. 95% Confidence Intervals (CI) of the success rates were calculated. Secondary outcomes included complication rates, coalition recurrence rates, revision rates and pain improvement using the Visual Analogue Scale (VAS). A sub-analysis on interposition material was performed.
RESULTS: 43 articles comprising of 1284 coalitions were included, with a pooled mean follow-up of 51 months. Methodological quality was fair. The overall pooled success rate for TCCs was 79% (95% CI, 75%-83%). Conservative treatment, open resection and arthroscopic resection of TCCs resulted in success rates of 58% (95% CI, 42%-73%), 80% (95% CI, 76%-84%) and 86% (95% CI, 71%-94%), respectively. CNCs have an overall success rate of 81% (95% CI, 75%-85%), with 100% (95% CI, 34%-100%), 80% (95% CI, 74%-85%) and 100% (95% CI, 65%-100%) for conservative treatment, open resection and arthroscopic resection, respectively. Pooled complication rates of 4% (95% CI, 3%-7%) for TCCs and 6% (95% CI, 4%-11%) for CNCs were found. The success rates of resection with and without interposition material for TCCs were 83% (95% CI, 78%-87%) and 79% (95% CI, 65%-88%), and for CNCs 81% (95% CI, 76%-86%) and 69% (95% CI, 44%-85%), respectively.
CONCLUSIONS: Treatment of tarsal coalitions can be considered good to excellent as well as safe, with an overall clinical success rate of 79% for TCCs and 81% for CNCs. Arthroscopic resection of the coalition appears to be non-inferior to open resection of TCCs and CNCs.
METHODS: Level IV, Systematic Review.
摘要：
背景：主要目的是确定距骨（TCC）和跟骨关节（CNC）治疗后的临床成功率。次要目的是评估并发症，复发率和翻修率。
方法：在MEDLINE中进行了搜索，EMBASE和Cochrane图书馆。使用非随机研究方法学指数（MINORS）标准评估方法学质量。主要结果是临床成功率，并按联合和治疗方式的类型进行汇总。计算成功率的95%置信区间(CI)。次要结果包括并发症发生率，联盟复发率，使用视觉模拟评分（VAS）的翻修率和疼痛改善。对插入材料进行子分析。
结果：包括了由1284个联盟组成的43篇文章，合并平均随访51个月。方法学质量一般。TCC的总体汇总成功率为79%(95%CI,75%-83%)。保守治疗,开放切除和关节镜下切除TCC的成功率为58％（95％CI，42％-73％），80%（95%CI，76%-84%）和86%（95%CI，71%-94%），分别。CNCs的总体成功率为81%(95%CI，75%-85%)，100%（95%CI，34%-100%），保守治疗的80%(95%CI,74%-85%)和100%(95%CI,65%-100%),开放切除术和关节镜切除术，分别。发现TCC的合并并发症发生率为4％（95％CI，3％-7％），CNCs的并发症发生率为6％（95％CI，4％-11％）。有和没有TCC介入材料的切除成功率分别为83％（95％CI，78％-87％）和79％（95％CI，65％-88％），CNCs为81%(95%CI，76%-86%)和69%(95%CI，44%-85%)，分别。
结论：治疗tal骨联盟可以被认为是良好的，良好的，以及安全的，TCC和CNCs的总体临床成功率为79%。联合关节镜切除似乎不劣于TCC和CNCs的开放切除。
方法：四级，系统审查。
方法：在MEDLINE中进行了搜索，EMBASE和Cochrane图书馆。使用非随机研究方法学指数（MINORS）标准评估方法学质量。主要结果是临床成功率，并按联合和治疗方式的类型进行汇总。计算成功率的95%置信区间(CI)。次要结果包括并发症发生率，联盟复发率，使用视觉模拟评分（VAS）的翻修率和疼痛改善。对插入材料进行子分析。
结果：包括了由1284个联盟组成的43篇文章，合并平均随访51个月。方法学质量一般。TCC的总体汇总成功率为79%(95%CI,75%-83%)。保守治疗,开放切除和关节镜下切除TCC的成功率为58％（95％CI，42％-73％），80%（95%CI，76%-84%）和86%（95%CI，71%-94%），分别。CNCs的总体成功率为81%(95%CI，75%-85%)，100%（95%CI，34%-100%），保守治疗的80%(95%CI,74%-85%)和100%(95%CI,65%-100%),开放切除术和关节镜切除术，分别。发现TCC的合并并发症发生率为4％（95％CI，3％-7％），CNCs的并发症发生率为6％（95％CI，4％-11％）。有和没有TCC介入材料的切除成功率分别为83％（95％CI，78％-87％）和79％（95％CI，65％-88％），CNCs为81%(95%CI，76%-86%)和69%(95%CI，44%-85%)，分别。
结论：治疗tal骨联盟可以被认为是良好的，良好的，以及安全的，TCC和CNCs的总体临床成功率为79%。联合关节镜切除似乎不劣于TCC和CNCs的开放切除。
方法：四级，系统审查。
