Rigid Page 2

Intraop Pics of CN Bar resection in 11 year old gymnast. (Patient SH)

Incision Placement and the ICDN nerve mapped to avoid injury.

The Retinaculum and EDB muscle identified prior to dissection

The CN Bar is identified with the instrument and resected.

The CN Bar is completely resected.

The EDB muscle is visualized and transposed into the space created by the resection to decrease the chance of bone regrowth.

Pre and Postop X-rays of Above Patient

Set of Cn Bar Excision Pics Below

Incision of CN Bar Excision and EDB Muscle belly visualized. The peroneal tendons can be seen under the muscle as they course into the foot. The instrument is showing the space between the EDB muscle and Peroneal Tendons

The coalition can be seen by the small cleft between the adjacent calcaneus and navicular. There should be space in between. The instrument is pointing to the coalition on the right picture.

The 2 osteotomes are about 10-12 mm apart to have a wide excision of the coalition.

The bone is removed from the foot.

The void left after resection

The EDB muscle is transposed into the coalition resection site, which acts a spacer and doesn't allow regrowth of the coalition.



The following images are that of a 3D reconstruction of a CT scan that demonstrates the coalition of the middle facet of the subtalar joint.

3D reconstructions and CT scan of Middle Facet Subtalar Tarsal Coalition (Arrows Pointing to Coalition)



This image is a coronal plane view of a CT scan also showing a middle facet coalition.



Combination Coalition

The following is an example of a 12 y/o female with a combination coalition of the middle and posterior facets that has stopped her from doing atheletic activites because of pain. The top images are the lateral view (left) and oblique view (right) of the middle and posterior facet. The bottom left is the axial view of the middle facet.

The next set of images are CT scans in the transverse or axial view that demonstrate the irregularity of the facet and arthritic changes occuring at the area which cause the individual pain with activity. The bottom set of images are a sequence of the CT scan to show the irregularities from the coalition and its extent.


Pic of flatfoot with stj arthirits treated with triple arthrodesis

Joints are realigned and in excellent positioning


Pic of flatfoot treated with triple arthrodesis

Joints are realigned and in excellent positioning

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