Tarsal Coalition

Abstract

Tarsal coalition is a congenital condition characterized by partial or complete fusion of two or more bones of the foot. The classic appearance of a symptomatic tarsal coalition is a rigid, flat foot, with the talocalcaneal (middle facet) and calcaneonavicular joints being the two most common sites of coalition. These typically become symptomatic in children and adolescents as the previously cartilaginous bridges begin to ossify. Although most tarsal coalitions are asymptomatic, some will result in pain, deformity, or functional limitations. Treatment should be aimed at relieving the symptoms and increasing functional ability to maintain an active lifestyle. Nonsurgical options include activity modification and resting the subtalar joint using a variety of casts, braces, and orthotics. Surgical options exist for those that remain symptomatic after conservative treatment and include resection of symptomatic coalitions or hindfoot arthrodesis (limited subtalar or triple).

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