Tarsal Coalition
What is a Tarsal Coalition?
A tarsal coalition is an abnormal connection of two or more bones in the foot. The bones affected — called tarsal bones — are located toward the back of the foot and in the heel, and the connection of the bones can result in a severe, rigid flatfoot.
There are two types of coalition:
- Congenital: Most common
- Acquired: Less common and caused by trauma, degeneration and infection
Signs and Symptoms
Asymptomatic:
- Most coalitions are found incidentally
- 75 percent of people are asymptomatic
Symptomatic:
- Previous medical history of repeated ankle sprains
- Location of pain can determine what type of coalition
- Pain worsened by activity – onset of symptoms correlates with age of ossification of coalition
Imaging
- Radiographs
- CT scan – assists to rule out additional coalitions and determine size and location of coalition
- MRI – may be helpful to visualize a fibrous or cartilaginous coalition
Treatment
Conservative:
- Continual observation for asymptomatic patients
- Shoe inserts
- Casting
Surgical Intervention:
- Surgical intervention is deemed necessary with persistent symptoms despite prolonged period of conservative management
- Shoe inserts
- Coalition involves <50% of joint surface
