Di Gennaro GL, Stallone S, Olivotto E, et al. - This study was undertaken to compare operative and nonoperative treatment in children with painful rigid flatfoot (RFF) with talocalcaneal coalition (TCC). Between 2005 and 2015, medical records and radiographs of children with RFF and TTC treated were retrospectively examined. Researchers recruited a total of 34 children (47 ft) in the nonoperative group and 21 children (34 ft) in the operative group. Compared with the nonoperative treatment, the operative treatment revealed better results. The results of this study demonstrate that symptomatic RFF with TCC in children can be effectively treated in one step with resection, graft interposition and subtalar arthroereisis. Future prospective randomized studies are required to verify the findings and to identify the best operative strategy in this condition.