Tarsal Coalition

Tarsal Coalition
Tarsal Coalition

Tarsal coalition is a congenital (born with it) fusion (sticking together) of the tarsal bones in the foot. The tarsals are 7 bones located at the back of the foot. These are the Calcaneus, Talus, Navicular, Cuboid and the three Cuneiform bones.

Symptoms of Tarsal Coalition

  • Symptoms usually do not appear until the bones have started to mature, between the ages of 10 and 16.

  • However some people will not display any symptoms until later on in life, possibly if they start to exercise or suffer an ankle sprain.

  • Foot pain in the midfoot in adolescents after hard training or activity.

  • This injury may become obvious after an ankle sprain when the pain does not appear to get better.

  • The arch of the foot collapses.

  • Reduced joint movement in the ankle.

  • Walking with a limp.

  • Stiffness in the foot and ankle.

  • Symptoms of tarsal tunnel syndrome – which can be caused by an unknown tarsal coalition.

  • An X-ray may show up an osseous coalition and an MRI may show up a fibrous one

 

What Causes Tarsal Coalition?

The most common joints to be affected are the calcaneonavicular joint (between the Calcaneus and the Navicular) and the talocalcaneal joint (between the Talus and the Calcaneus).

It usually affects adolescents as the fibrous or cartilaginous joints between the bones ossify (turn to bone) and harden. This causes a decreased range of motion in the rearfoot causing strain on the ankle joint.

Tarsal coalition can occasionally develop in later life due to an infection or arthritis in the joints, or an ankle injury.
Diagnosis

A thorough examination with a full medical history is used to determine the possibility of a tarsal coalition. An X-ray or other more advanced imaging studies should be used to confirm the diagnosis.
Treatment Options

  • Cast or walking boot to allow proper rest to reduce the pain and inflammation.

  • Biomechanical problems should be corrected.

  • This may require insoles or orthotics.

  • Exercises to improve mobility may also be advised.

  • Corticosteroid injections are sometimes also recommended.

  • Tarsal Coalition Surgery- If conservative treatment fails, surgical treatment may be required. Surgery may be used to either excise (remove) the excess bone growth, or to completely fuse the two joints.