What is a tarsal coalition?
Tarsal coalitions are abnormal connections between the bones of the foot which may cause loss of motion and pain.

What is the incidence of tarsal coalition?
The incidence is reported between 0.03% and 1.0% of the population.

Where are these connections found?
These abnormal connections are most common between the tarsal bones (bones in the middle of the foot) such as the talocalcaneal and talonavicular joints.

What causes a tarsal coalition?
The etiology of tarsal coalitions is probably associated with failure of the tarsal bones to fully divide during their development. Subsequently, these abnormally formed joints limit motion or cause complete loss of motion which then interferes with the function of the nearby joints in the foot and ankle.

What are the symptoms of a tarsal coalition?
The symptoms of a tarsal coalition usually occur in early adolescence. Recurrent ankle sprains may be the only complaint, but pain at the site of the coalition does occur and may significantly limit activities. It is important to recognize that not all coalitions cause pain and disability; therefore, a thorough physical examination is necessary to access joint motion (movement) and to localize pain.

Will x-rays be taken?
Plain x-rays are very helpful in identifying a tarsal coalition but other studies may be necessary to localize and quantitate the size of the abnormal development of these bones. Radiographs may reveal the bony bridge between the tarsal bones (bones in the middle of the foot) or show changes in the nearby joints. A CT scan and/or a MRI may useful in the evaluation of a tarsal coalition.

How are tarsal coalitions treated?
Initial treatment includes conservative (non-operative) measures to relieve pain. These may include foot orthotics (shoe inserts), casting and anti-inflammatory medications. Patients that continue to have pain despite these treatments may be candidates for surgical intervention. Surgery for tarsal coalitions include: removal/excision of the attachment between the bones or fusion of the joint (taking away the joint between 2 bones). Treatment depends on the size, location and character of the coalition (bridge of bone). With the above treatment, most patients show improvement in their symptoms and may fully return to their activities.