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Forty-three pediatric patients (58 feet) confirmed by 3D CT are classified into type I (middle facet), type II (posterior facet), and type III (extra-articular). Three orthopedic surgeons assess interobserver agreement while hindfoot alignment, pain, peroneal spasm, tarsal tunnel syndrome, treatment strategies, operative time, AOFAS/VAS outcomes, and complications are recorded. Results show nearly perfect agreement (kappa 0.90) and type-linked clinical patterns with improved scores and type III shortest operative time.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/a-clinically-relevant-classification-system-for-pediatric-talocalcaneal-coalition-research-findings-summary/460598/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/a-clinically-relevant-classification-system-for-pediatric-talocalcaneal-coalition-research-findings-summary/460598.png","ImageObject",300,407,{"name":92,"@type":93},"Ivy","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What problem does the study aim to solve for pediatric talocalcaneal coalition classification?","Question",{"text":112,"@type":113},"Existing TCC classifications are limited and rely mainly on histologic or morphologic features without strong clinical correlation or therapeutic guidance, and no pediatric-specific system exists.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were patients classified in this study?",{"text":117,"@type":113},"Forty-three pediatric patients (58 feet) confirmed by 3D CT were classified into type I (middle facet), type II (posterior facet), and type III (extra-articular) using the novel classification system.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main results regarding agreement and clinical outcomes?",{"text":121,"@type":113},"The system showed almost perfect interobserver agreement (kappa = 0.90). All types achieved significant AOFAS/VAS improvement, and type III had the shortest operative time with no complications.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},460598,1790817719,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},549758252649,"https://ap-avatar.wpscdn.com/avatar/8000253669c5317157?_k=1778319167496531819","A Clinically Relevant Classification System for Pediatric  \nTalocalcaneal Coalition  \nXiong-tao Li, MD, Xian-tao Shen, MD, Xing Wu, MD, and Zhi-guo Zhou, MD  \nIntroduction: Talocalcaneal coalition (TCC) is one of the most common tarsal coalitions in children. However, current classifications of TCC are limited and focus on histologic or morphologic features without clinical correlation or therapeutic guidance. Moreover, no classification system specifically designed for pediatric populations. We hypothesize that the novel classification system will be clinically relevant, reliable, and easy to use for pediatric TCC management.  \nMethods: A total of 43 patients (58 feet) with pediatric TCC confirmed by 3-dimensional CT scans were included in this study. All cases were classified according to the novel classification system: type I (middle facet TCC), type II (posterior facet TCC), and type III (extra-articular TCC) . Three pediatric orthopaedic surgeons with varying levels of experience independently classified the 58 cases to assess interobserver agreement. For all patients, we documented the hindfoot alignment (valgus, varus, or neutral), presence of pain, peroneal muscle spasm, tarsal tunnel syndrome, treatment strategies, surgical duration, preoperative and postoperative AOFAS and VAS scores, and complications.  \nFrom the Department of Orthopedics Surgery, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.  \nThis study was supported by the Scientific Research Projects from Wuhan Municipal Health Commission (WX23A10) and the Soaring Plan of Youth Talent Development in Wuhan Children’s Hospital (2023TFJH01) and Hubei Province Health Science and Technology Project (WJ2023ZH007) .  \nX.-t.L.: study design, collected and analyzed the data, and manuscript preparation. X.-t. S: study design, collected and analyzed the data, manuscript preparation. X.W.: collected and analyzed the data, manuscript preparation. Z.-g.Z.: collected and analyzed the data, manuscript preparation.  \nThis work was approved by the Research Ethics Board of the Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science & Technology.  \nThe authors declare no conflicts of interest.  \nReprints: Xiong-tao Li, MD, Department of Orthopedics Surgery, Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science & Technology, No. 100 Hong-Kong Road, Jiang’an District, Wuhan City 430014, PR China. E-mail: [lixiongtao0604@126.com](lixiongtao0604@126.com).  \nCopyright © 2025 The Author(s) . Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.  \nDOI: 10.1097/BPO.0000000000003103  \n[74](74 | www.pedorthopaedics.com)[ |](74 | www.pedorthopaedics.com)[ www.pedorthopaedics.com](74 | www.pedorthopaedics.com)  \nResults: A total of 22 type I, 9 type II, and 27 type III TCC cases were identified, with a mean age of 10 .9 years. The new classification system demonstrated almost perfect interobserver agreement (kappa = 0.90) . Type I showed the highest valgus prevalence (59%, 13/22; P = 0.004), type II predominant varus (67%, 6/9; P \u003C 0.001), and type III neutral alignment (52%, 14/27; P = 0. 515) . Medial displacement calcaneal osteotomy was performed in 14%(3/21) of type I cases, and lateral displacement osteotomy in 42%(5/12) of type II and III cases. All types achieved significant AOFAS/VAS improvement. Type III TCC had the shortest operative time (52 min; P \u003C 0.001) and no complications.  \nConclusion: We propose a novel classification system for pediatric TCC that is clinically relevant, reliable, and easy to use. Type I TCC is more often associated with hindfoot valgus, whi","cbCaikbeh9pg6muU","https://ap.wps.com/l/cbCaikbeh9pg6muU","pdf",547686,"English","# Introduction\n# Methods\n# Results\n# Conclusion\n# Level of Evidence\n# Key Words","[{\"question\":\"What problem does the study aim to solve for pediatric talocalcaneal coalition classification?\",\"answer\":\"Existing TCC classifications are limited and rely mainly on histologic or morphologic features without strong clinical correlation or therapeutic guidance, and no pediatric-specific system exists.\"},{\"question\":\"How were patients classified in this study?\",\"answer\":\"Forty-three pediatric patients (58 feet) confirmed by 3D CT were classified into type I (middle facet), type II (posterior facet), and type III (extra-articular) using the novel classification system.\"},{\"question\":\"What were the main results regarding agreement and clinical outcomes?\",\"answer\":\"The system showed almost perfect interobserver agreement (kappa = 0.90). All types achieved significant AOFAS/VAS improvement, and type III had the shortest operative time with no complications.\"}]","A Clinically Relevant Classification System for Pediatric Talocalcaneal Coalition - Research Findings Summary | PDF",1790758867,18]