TARSAL COALITION
WHAT IS IT?
A tarsal coalition is an abnormal connection that develops between two bones in the back of the foot (the tarsal bones). This abnormal connection, which can be composed of bone, cartilage or fibrous tissue, may lead to limited motion and pain in one or both feet.
The tarsal bones include the calcaneus (heel bone), talus, navicular, cuboid and cuneiform bones. These bones work together to provide the motion necessary for normal foot function.
CAUSES
Most often, tarsal coalition occurs during fetal development, resulting in the individual bones not forming properly. Less common causes of tarsal coalition include infection, arthritis or a previous injury to the area.
SYMPTOMS
While many people who have a tarsal coalition are born with this condition, the symptoms generally do not appear until the bones begin to mature, usually around ages 9 to 16. Sometimes no symptoms are present during childhood. However, pain and symptoms may develop later in life.
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
- Flatfoot (in one or both feet)
- Walking with a limp
- Stiffness of the foot and ankle
TREATMENT
Nonsurgical Treatment
The goal of nonsurgical treatment of tarsal coalition is to relieve the symptoms and to reduce the motion at the aected joint. One or more of the following options may be used, depending on the severity of the condition and the response to treatment:
- Oral medications. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may be helpful in reducing the pain and inflammation.
- Physical therapy. Physical therapy may include massage, range-of-motion exercises and ultrasound therapy.
- Steroid injections. An injection of cortisone into the affected joint reduces the inflammation and pain. Sometimes more than one injection is necessary.
- Orthotic devices. Custom orthotic devices can be beneficial in distributing weight away from the joint, limiting motion at the joint and relieving pain.
- Immobilization. Sometimes the foot is immobilized to give the affected area a rest. The foot is placed in a cast or cast boot, and crutches are used to avoid placing weight on the foot.
- Injection of an anesthetic agent. Injection of an anesthetic into the leg may be used to relax spasms and is oen performed prior to immobilization.
When Is Surgery Needed?
If the patient's symptoms are not adequately relieved with nonsurgical treatment, surgery is an option. The foot and ankle surgeon will determine the best surgical approach based the patient's age, condition, arthritic changes and activity level.
WHY CHOOSE A FOOT AND ANKLE SURGEON?
Foot and ankle surgeons are the leading experts in foot and ankle care today. As doctors of podiatric medicine – also known as podiatrists, DPMs or occasionally “foot and ankle doctors” – they are the board-certified surgical specialists of the podiatric profession. Foot and ankle surgeons have more education and training specific to the foot and ankle than any other healthcare provider.
Foot and ankle surgeons treat all conditions affecting the foot and ankle, from the simple to the complex, in patients of all ages including Haglund's deformity. Their intensive education and training qualify foot and ankle surgeons to perform a wide range of surgeries, including any surgery that may be indicated for Haglund's deformity.
