Tarsal coalition: Systematic review of arthroscopic management.

INTRODUCTION: The standard of care in the treatment of symptomatic tarsal coalitions is open surgery. However, certain limitations exist with open surgery, which include limited visualization leading to an incomplete resection and possible recurrence of the tarsal coalition. Arthroscopic tarsal coalition resection (TCR) is an alternative that is gaining traction, primarily as the safety profile of posterior ankle and subtalar arthroscopy is more well understood. This study provides a systematic review of the outcomes of arthroscopic TCR. METHODS: PubMed and Embase were searched independently by 2 reviewers for relevant articles based on predetermined criteria. The subject heading "tarsal coalition" and its related key terms were used. RESULTS: A total of 416 studies were revealed by the initial search, out of which only 6 met our predetermined inclusion criteria. A total of 42 patients (average age: 17.6 years) were treated with arthroscopic TCR. Thirty-three (78.6%) and 9 (21.4%) patients had talocalcaneal and calcaneonavicular coalitions, respectively. The follow-up period ranged from 6 to 60 months (mean: 26 months), and no recurrence of the tarsal coalition was detected (0.0%). Complications occurred in two (4.8%) patients only, with one developing complex regional pain syndrome (CRPS), and another patient developing hyperesthesia on the medial aspect of the calcaneus. CONCLUSION: Arthroscopic TCR is a feasible and effective surgery for both CNC and TCC with minimal complications and no disease recurrence at an average of 26 months follow-up. Future high-level of evidence studies are needed to compare the outcomes of open versus arthroscopic TCR.

Endoscopic fasciotomy for chronic exertional compartment syndrome of the forearm: Systematic review of outcomes and complications.

BACKGROUND: Endoscopic fasciotomy of the forearm for chronic exertional compartment syndrome (CECS) has gained popularity recently. AIM: To systematically review the literature of endoscopic fasciotomy for CECS of the forearm, aiming to assess the outcomes and complications of the different endoscopic fasciotomy techniques described in the literature. METHODS: On January 18, 2021, PubMed and EMBASE were searched by 3 reviewers independently, and all relevant studies published up to that date were considered based on predetermined inclusion/exclusion criteria. The subject headings "endoscopic fasciotomy" and "compartment syndrome" and their related key terms were used. The Preferred Reporting Item for Systematic Reviews and Meta-Analyses statement was used to screen the articles. RESULTS: A total of seven studies including 183 patients (355 forearms) were included. The mean age of the patients was 31.2 years (range: 15-42 years). The postoperative follow-up duration ranged from 6 wk to 4.9 years. All patients were able to return to sport activities between postoperative weeks 1 to 8. Recurrence of the compartment syndrome occurred in three patients, giving a rate of 1.6% per patient and 0.8% per forearm. The overall complication rate was 8.7% per patient, and 4.5% per forearm. The most common reported complication was hematoma (7 forearms; 2.0%). CONCLUSION: Endoscopic fasciotomy for CECS of the forearm has favorable short- and mid-term outcomes with very low recurrence and complication rates. This, however, needs to be confirmed in larger, long-term follow-up, prospective, comparative studies between open, mini-open and endoscopic fasciotomy techniques.