Description. A tarsal coalition occurs
when two bones grow into one another
, connected by a bridge of bone, cartilage, or strong, fibrous tissue. These bridges are often referred to as “bars” and they can cover just a small amount of the joint space between the bones, or a large portion of the space.
Tarsal coalition is usually an inherited condition. It occurs when individual bones in the foot do not form properly when a fetus is developing. Less common causes for the condition are
arthritis, infections and a prior injury to the area
.
What is fibrous Talocalcaneal coalition?
Talocalcaneal coalition or peroneal spastic foot or subtalar coalition is an
anomalous connection between the talus and the calcaneum
that can present with painful and rigid flat-foot in older children and adolescents. … The talocalcaneal coalition can be fibrous, cartilaginous, or bony.
Calcaneonavicular tarsal coalition is
an abnormal union bridge between the calcaneus and the navicular or tarsal scaphoid bone
, and may be osseous (synostosis), cartilaginous (synchondrosis) or fibrous (synfibrosis or syndesmosis). … Along with the talocalcaneal form, it is the most frequent tarsal coalition.
What is Calcaneocuboid coalition?
The calcaneocuboid joint occurs
between the anterior process of the calcaneus and the cuboid
, which are joined by the bifurcate ligament (Fig. 2). This joint acts in concert with the talonavicular joint, the Chopart joint, as the articulation between the hindfoot and the midfoot.
Can tarsal coalition be fixed?
Most children with tarsal coalition can
be treated with nonsurgical options
such as orthotics and physical therapy. If your child has severe symptoms, does not respond to nonsurgical treatments, and the condition interferes with their daily activities, doctors may recommend surgery.
What happens if tarsal coalition goes untreated?
What if tarsal coalition goes untreated? Over time,
a child, teen, or young adult may experience enough pain that they can’t do the activities they enjoy
. Later in life, they may have a very stiff foot (indicating a large coalition). The foot may be so stiff and painful that surgical repair is no longer an option.
Is tarsal coalition a disability?
Tarsal coalitions
may cause altered foot biomechanics leading to patient disability from osteoarthritis and other sequelae
. While some types of coalition are common, isolated talonavicular coalitions are relatively rare.
How long does it take to recover from tarsal coalition surgery?
The recovery time may take
6-12 months
. The success of the resection procedure cannot be guaranteed and is dependent upon a number of factors, including the person’s age, the extent of the connection between the tarsal bones, and whether there is degenerative arthritis in the nearby joints.
Is tarsal coalition serious?
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.
What does tarsal coalition feel like?
The symptoms of tarsal coalition may include one or more of the following:
Pain (mild to severe) when walking or standing
.
Tired or fatigued legs
.
Muscle spasms in the leg
, causing the foot to turn outward when walking.
Summary. Calcaneonavicular coalition is
a common source of pain and more or less severe flat and stiff foot in children
. Classically, treatment consists in resecting the coalition using a dorsolateral approach. Good quality resection and interposition can prevent recurrence.
Is tarsal coalition always noted with an xray?
Imaging Diagnosis
If the diagnosis is suspected,
tarsal coalition can typically be identified on plain x-ray
, particularly in the oblique view (see below). Of note, if the patient’s coalition is more fibrous tissue than bone, it may not always show up on a plain x-ray.
Can tarsal coalition cause back pain?
Coalitions often cause a rigid flat foot, and that can be a tremendous source of arch pain and fatigue. A severe flat foot may push the heel bone into the ankle bone, and irritate tendons on the outside of the foot. Additionally, coalitions
can produce arthritis in the back part of the foot
, resulting in achy pains.
Can you run with tarsal coalition?
Clinical relevance: Regaining full recreational activity after resection of a tarsal coalition, i.e. running,
may have implications on abnormal foot loading and torque
, thus promoting degenerative changes in the subtalar and adjacent joints.
Does tarsal coalition cause plantar fasciitis?
There are many possible causes for foot pain, from
plantar fasciitis
to fractures, foot neuromas and bone spurs. One such cause is a tarsal coalition. Dr. Stuart Katchis, NY-based orthopedic surgeon specializing in the foot and ankle, has treated many young patients with tarsal coalitions.
