Tarsal coalitions

Coalitions are abnormal joins between bones of the foot that should normally be separated by a joint. There are 2 common types and several very rare types. Coalitions actually are thereĀ at birth but present in middle childhood from about 10 years old. This is because the join between the bones begins as a flexible piece of tissue (fibrous or cartilage) and then turns into bone which becomes stiffer as the child grows. A mature coalition will allow no movement and the 2 bones that it joins act as one piece of bone.

The common two coalitions are calcaneonavicular and talocalcaneal.

Calcaneonavicular tarsal coalition

An abnormal join can be seen between the heel bone (calcaneum) and the navicular hence – calcaneo-navicular

Children present with pain in the foot and stiffness. Activity usually makes the symptoms worse and sport is affected. Treatment is typically with an orthotic (insole) to help the position of the foot and pain relief and anti-inflammatories. Physiotherapy may help secondary problems such as shortening of the calf and other lower leg muscles.

Many patients will not be able to return to a desired level of activity and surgery can be very effective at solving the problem by removing the joining piece of bone. In some cases the join may be too big to remove and so other operations may be used to change the shape of the foot to help improve function.

Details of the operation for tarsal coalition